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. :  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...

Read More

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...

Read More

Assessing Call Demand and Utilization of a Secondary Triage Emergency Communication Nurse System for Low Acuity Calls Transferred from an Emergency Dispatch System

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...

Read More

An Exploration of Sources, Symptoms and Buffers of Occupational Stress in 9-1-1 Emergency Call Centers

 9-1-1 telecommunicators are uniquely exposed to numerous occupational stressors on an ongoing basis. Yet little is known about the sources of occupational stress and symptoms of stress in these workers and even less is known about variables that can serve as stressors or buffers to stress in the 9-1-1 call center work environment. : We sought to explore the inter-relationships amongst job stressors, potential risk and protective factors, and symptoms of stress in 9-1-1 telecommunicators. Our long-term goal was to use outcomes of this study to guide and...

Read More

The Need for Better Access to Prehospital Emergency Medical Services for Seizure Patients in Rural India: A Profile of Clinical and Etiological Characteristics Compared With Ambulance Usage in a Rural Region

Seizures are episodes of sudden, severe, disorganized neurological activity in the brain, characterized by uncontrolled movement and, in many cases, altered consciousness. Seizures account for 1% of all emergency department visits, and are a leading cause of Emergency Medical Services (EMS) activation and transport. Patients who experience a seizure with no medical history of seizure disorder challenge the prehospital provider to identify an underlying cause for the event and attempt to treat immediately. s:This study aimed to identify the clinical profile of...

Read More

Emergency Medical Dispatchers’ Ability to Determine Obvious or Expected Death Outcomes Using a Medical Priority Dispatch Protocol

Emergency Medical Dispatchers (EMDs), at emergency communication centers that have implemented the Medical Priority Dispatch System® (MPDS) protocols, use scripted questions to interrogate people calling 9-1-1. Based on this interrogation, case determinant codes are assigned– to identify the specific patient condition and enable optimal allocation and deployment of resources to ensure appropriate field responses. MPDS determinant codes for both OBVIOUS and EXPECTED DEATH exist for patients that are clearly and irreversibly dead, or have a terminal illness accompanied...

Read More

Is Dispatching to a Traffic Accident as Stressful as Being in One? Acute Stress Disorder, Secondary Traumatic Stress, and Occupational Burnout in 911 Emergency Dispatchers

Emergency dispatchers are exposed to potentially traumatic events at rates that likely exceed that of emergency first responders. Although not physically present at the time of the incident, it is likely that this repeated exposure in concert with highly stressful work conditions could lead to potentially negative emotional and physical outcomes. To date few studies have examined rates of stress related pathology and subsequent impairment in emergency dispatchers. The following study takes an initial step to investigate rates of Acute Stress Disorder, Secondary Traumatic Stress and...

Read More

Call Prioritization Time in a Fire Priority Dispatch System

This study represents a first attempt to classify a subset of time-to-dispatch in a 911 center – the call prioritization time. This time is defined as the time required to gather critical case information, after the address is obtained, and prior to notifying responder units of the call. This study characterizes call prioritization time in nine different 911 centers, all using the Fire Priority Dispatch System (FPDS). Times were examined by individual agency, overall, Methods: This was a retrospective, non-controlled, descriptive study involving nine 911 and by FPDS...

Read More

The Distribution of Recommended Care Levels by Age, Gender, and Trauma vs Medical Classification within the Emergency Communication Nurse System

An examination of the Emergency Communications Nurse-determined Recommended Care Levels (RCLs), for calls transferred for secondary nurse-triage has not been performed.  The outcome of such an investigation would help to gain a more complete picture of the type of care ultimately recommended for these patients. The Emergency Communications Nurse System (ECNS) studied contained 22 RCLs, ranging from urgent levels, including a country-specific 3-digit number Emergency response (911), and Emergency care as soon as possible to less time-dependent, low priority levels, such...

Read More

911 Emergency Communication Nurse Triage Reduces EMS Patient Costs and Directs Patients to High-Satisfaction Alternative Point of Care

Recent estimates indicate that more than half of all Emergency Department (ED) visits could be avoided, reducing patient costs and increasing satisfaction with care.  Since 911 is increasingly the first point of contact for many patients entering the health care system—even those with non-emergency conditions—one potential approach to decreasing emergency costs and ED overcrowding is to reinvent the 911 dispatch center as a clearinghouse for directing patients to alternative care providers.  This study presents a cost avoidance analysis of two 911 dispatch centers that...

Read More

Join the AEDR Newsletter