Most UK ambulance services undertake remote clinical consultation of 999 emergency calls.

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Most UK ambulance services undertake a secondary assessment of 999 calls with nurses and paramedics to best manage delays in responses and reduce inappropriate admissions to hospitals. However, little is known about the differences in the types of cases managed by the two professions comparatively, their clinical outcomes, and the quality and safety they offer.

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Most United Kingdom (UK) ambulance services undertake remote clinical consultation of 999 emergency calls, often using computerised decision support systems, such as the Emergency Communication Nurse System (ECNS). In 2021 the Welsh Ambulance Services NHS Trust implemented ECNS in a novel way. Both nurses and paramedics used the tool to assess the full range of Advanced Medical Priority Dispatch System (AMPDS) codes and acuities. This study reports the ECNS outcomes of the full range of AMPDS codes, aiming to inform future discussion, protocol evolution, and clinical models internationally.

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The Welsh Ambulance Service NHS Trust (WAST) manages more than 500,000 calls every year, with its emergency ambulance staff attending more than 250,000 of these calls. WAST currently uses the Medical Priority Dispatch System to process its 999 emergency calls and is an accredited centre of excellence. WAST employs experienced nurses and paramedics to undertake 999 secondary telephone triages of 1) low acuity patients, 2) patients awaiting an ambulance response, and 3) patients whose condition may be managed effectively by an alternative to an ambulance...

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The primary objective of this study was to determine the ability of an Emergency Communication Nurse (ECN) to appropriately identify the Abdominal Pain Chief Complaint Protocol to use to triage patients in low-acuity cases. The secondary objectives were to establish the most frequently used primary triage code (Medical Priority Dispatch System™ (MPDS®) Determinant Codes), triggering the use of the Abdominal Pain Chief Complaint Protocol in the Emergency Communication Nurse System™ (ECNS™), as well as the percentage of these calls resulting in a Recommended Care Level (RCL) of “emergency a

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The overall objective of the study was to determine whether layperson callers can effectively stop simulated bleeding using an improvised or a commercial tourniquet, when provided with scripted instructions via phone from a trained protocol-aided EMD.

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Abdominal pain is the most common symptom with which patients present to the emergency department (ED), and overall visits to EDs in the U.S. are growing twice as fast as the overall population. Interventions that can safely mitigate such a high usage of ED resources would be a great asset in the delivery of effective and efficient ED care. One such intervention is a secondary triage of patients calling 911 for an ambulance who were subsequently triaged as a non-urgent low-acuity caller. Emergency medical services (EMS) using secondary...

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The Health Contact Centre (HCC) in Brisbane Australia is one of the Health Support Queensland's services that provides clinical support, either directly to the community (4.7 million Queenslanders) or in support of Hospital and Health Services (HHS) and the Department of Health. Registered nurses (RNs) use the Emergency Communication Nurse System™ (ECNS™) as Clinical Decision Software System (CDSS) to triage callers who access this service via telephone. The RN uses a set of symptom-based protocols in the ECNS to telephonically triage the caller/patient and recommends the most...

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Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...

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Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...

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