Effects of a Prehospital Emergency Care System on the Treatment and Prognosis of Stroke Patients

We sought to study a recently implemented prehospital emergency care system and its effects on the treatment level and prognosis of stroke patients. Prior to the introduction of the new system, no dispatch triage or prehospital care was available, and most patients accessed emergency care directly, without calling an emergency number. Methods: From April 2014 to March 2015,, at our associate hospital’s emergency department, 325 first-time acute stroke patients were admitted to the emergency department. This cohort was divided according to hospital admission method. The...

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Comparison of Emergency Medical Dispatcher Stroke Identification and Paramedic On-Scene Stroke Assessment

Some have argued that there is no need for a dispatcher stroke evaluation because emergency medical services (EMS) responders can perform a more detailed, in-person stroke evaluation in the field. In fact, little or no research exists to determine whether dispatch stroke evaluations are actually redundant when compared with EMS field responder assessments. Objective: The purpose of this study is to determine whether some strokes identified by emergency medical dispatchers (EMDs) are not identified by field paramedics. Methods: The descriptive study utilized data from...

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Call Prioritization Times for Structure Fires in a Fire Priority Dispatch System

While Structure Fire is not the most common Chief Complaint handled by Emergency Fire Dispatchers (EFDs), the high death toll and other serious consequences that result make structure fires one of the most important types of calls EFDs handle.  The time needed to appropriately and effectively prioritize these calls can be evaluated using a time standard called Call Prioritization Time (CPT). In this study, we evaluate CPT for centers using the Fire Priority Dispatch System (FPDS). Objectives: The primary objective in this study was to determine CPT for the FPDS...

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Characterization of Hospital-Confirmed Stroke Evidence for Callers Who Were Unable to Complete Stroke Test Requests from the Emergency Medical Dispatcher

The findings of a recent study suggest that a patient’s inability to complete all three tasks in a stroke identification tool used by Emergency Medical Dispatchers (EMDs) is a uniquely strong predictor of stroke. Objectives: To examine the characteristics of the 17 cases in which the patient was unable to complete all three tasks in the Stroke Diagnostic Tool (SDxT). Methods: The retrospective descriptive study utilized stroke data from three sources in Salt Lake County, Utah, USA—Emergency Medical Dispatch, emergency medical services (EMS), and receiving hospitals—for...

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Communication Factors Associated with Stroke Identification During Emergency Calls: A Systematic Review

The first opportunity for prompt identification of a stroke in the prehospital environment often occurs when people telephone for emergency medical services. A better understanding of how callers and dispatchers communicate during emergency calls may assist dispatcher identification of stroke. Objective: To conduct a systematic review of the literature to determine communication factors associated with the identification of stroke during emergency calls. Methods: Six databases were searched (CINAHL, Cochrane, Embase, Informit, MEDLINE and PsychInfo). To meet...

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Continuous Dispatch Education and Service Improvement

Continuous Dispatch Education (CDE) is ongoing training for Emergency Dispatchers, Quality Improvement Specialists and Emergency Telecommunicators (ETC). Yorkshire Ambulance Service (YAS) wanted to improve current compliance performance to the Medical Priority Dispatch System™ (MPDS®) utilizing CDE. This study reports on the effectiveness of CDE efforts and staff motivation in completing CDE. Objectives: The primary objectives in this study were to establish if structured CDE improved calltaker performance and to gather information about staff perceptions of CDE. The...

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Current Methods and Factors Influencing Successful Training of Emergency Dispatchers in Emergency Communication Centers

Based on known unpublished sources (e.g. emergency communication center managers, training officers, dispatchers), emergency communication centers (ECCs) around the world provide training for new emergency dispatchers and continuing dispatcher education. However, little information has been collected, or shared, between ECCs regarding specific training methods that are being used, which methods are successful, and what factors influence their success. Objective: The objective of this study was to describe what training methods are currently being used in emergency...

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Research Literacy Among Emergency Dispatchers at an Emergency Communication Center: Developing Capacity for Evidence-Based Practice at Dispatch (A Pilot Report)

Expanding the role of evidence-based practice (EBP) in emergency medical services is a matter of increasing importance to researchers and practitioners alike. However, this movement toward EBP has not yet been applied to one critical area of prehospital care: emergency dispatching.  The primary reason for this gap is that emergency dispatchers (EDs) struggle to develop a research culture able to produce enough well-conducted studies to move toward true EBP. One starting point with documented potential for building the research capacity in a field is to develop...

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Characterization of Call Prioritization Time in a Medical Priority Dispatch System

Emergency Medical Services (EMS) agencies have a pressing need to understand call prioritization time (CPT), a key sub-component of call processing time in Emergency Medical Dispatch, as it impacts response time to specific cases and overall EMS agency response time performance. Objective:  The objective of this study was to determine median CPT by dispatch priority level and Chief Complaint type. Methods: This retrospective study included data from six emergency communication agencies, each accredited by the International Academies of Emergency Dispatch (IAED). The...

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The Distribution of Recommended Care Level Classification by Time of Day within the Emergency Communication Nurse System

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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