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AEDR 2015 Vol. 3 Issue 2

A Curious Case of Self-Diagnosis

Andrew Love, RN

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Case Study

Clinical call handlers at a contact center in Queensland Health, Australia, use a clinical decision support system (CDSS) called Priority Solutions Integrated Access Management (PSIAM™) (PSIAM version 3.6.1.1, 2012 release, Priority Solutions Inc., Salt Lake City, USA) to provide community members with telephonic triage, referrals, and health information. The contact center operates 24 hours a day, 7 days a week, and all calls are handled by Registered Nurses (RNs). Callers requiring emergency services, usually an ambulance attendance, are transferred to Emergency Medical...

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The Description of Hierarchy Bias Concept in Emergency Dispatch Coding and its Implications for Accuracy in Response and Outcome-based Studies

Jeff J. Clawson, MD, Rich Saalsaa, Christopher Olola, PhD, Jerry Overton

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Concept Papers

The value of dispatch in modern Emergency Medical Services (EMS) systems cannot be understated. Among many other roles, an Emergency Medical Dispatcher (EMD) is responsible for accurate response selection. Response is based on EMD-assigned dispatch codes upon completion of caller-interrogation questions in a dispatch protocol system. When two or more signs, symptoms, or situational conditions are encountered in a calltaker evaluation, but are assigned and reported as a single, dispatch-defined code descriptor during the call-taking process by an EMD, a data hiding...

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

Ivan Whitaker, MBA, Christopher Olola, PhD, Corike Toxopeus, PhD, Greg Scott, MBA, EMD-QI, Jeff J. Clawson, MD, Bryon Schultz, BA, Donald Robinson, Christopher Calabro, Isabel Gardett, PhD, Brett Patterson

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

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...

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

Dr. Mark Conrad Fivaz, Greg Scott, MBA, EMD-QI, Jeff J. Clawson, MD, Corike Toxopeus, PhD, Matt Zavadsky, MS, Kristen Miller, JD, Neal Richmond, MD, FACEP, Christopher Olola, PhD

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

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

Dr. Mark Conrad Fivaz, Greg Scott, MBA, EMD-QI, Jeff J. Clawson, MD, Corike Toxopeus, PhD, Matt Zavadsky, MS, Kristen Miller, JD, Neal Richmond, MD, FACEP, Christopher Olola, PhD

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

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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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

Neelima Saoji, MD, Chetan Dhoble, MD, Abhinav Arora, MD, Rosa Rios, MD

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

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...

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

Hendrika Meischke, PhD, MPH, Ian Painter, Michele Lilly, Randal Beaton, Debra Revere, Becca Calhoun, K. D. Seeley, Yvonne Carslay, Cathy Moe, Janet Baseman

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

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...

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FBI National Data Exchange System's On-Line Tool Enhances Dispatching by Law Enforcement Agencies throughout the US

Kasey Wertheim, Kelly Badgett

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Perspectives

The traffic stop began like any other. The officer radioed to dispatch with the license plate number and a National Crime Information Center (NCIC) search was conducted. The search turned up negative – showing nothing unusual about the vehicle or its owner – and the officer started a routine approach to the vehicle. The dispatcher then searched the license plate number through the Federal Bureau of Investigation's (FBI) newest System, the National Data Exchange (N-DEx). for short. Moments before the officer reached the driver's side window, dispatch returned with some relevant information...

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Time to First Compression using Medical Priority Dispatch System Compression- First Dispatch-CPR Protocols

Lee Van Vleet

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Research Posters

Without bystander CPR, cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) has been shown to increase the rates of bystander CPR and cardiac arrest survival. Other reports suggest that the most critical component of bystander CPR is chest compressions with minimal interruption. Beginning with version 11.2 of the Medical Priority Dispatch System™ (MPDS) protocols, instructions for mouthto-mouth ventilation (MTMV) and pulse-check were removed and a compressions-first pathway introduced to facilitate rapid delivery of...

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Time to First Compression Using Medical Priority Dispatch System CPR Pre-Arrival Instructions Does Not Vary With Dispatcher Experience

Lee Van Vleet

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Research Posters

In the absence of bystander Cardiopulmonary Resuscitation (CPR), cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) increase rates of bystander CPR and cardiac arrest survival, with chest compressions recognized as the most important component of bystander CPR. To facilitate rapid delivery of chest compressions, the Medical Priority Dispatch System (MPDS™) altered instructions for mouth-tomouth ventilation (MTMV) and removed pulse-check, plus other minor changes to the D-CPR pre-arrival instructions. However, factors beyond...

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