Few studies have described the clinical course and outcome of specific cohorts of patients identified by their 911 call type. Chest pain patients are especially important to study due to the time-sensitive nature of cardiac-related treatment. To describe the clinical course and outcome of patients identified as an MPDS Card 10 (Chest Pain), including the positive predictive value (PPV), with primary Emergency Department (ED) diagnosis. All 911 calls between November 1, 2011 and July 31, 2013, handled on Card 10 and pertaining to a patient...
The evaluation of emergency calls received by Emergency Medical Communication Centers (EMCCs) is the first and most basic step to activating the rescue chain. It also represents an essential prerequisite for an optimal management of critical patients, by optimizing the methods of public medical response and management time. The goal of the study is to evaluate whether the introduction of the Medical Priority Dispatch System™ (MPDS)® made more homogenous the evaluation of emergency calls among the five EMCCs in Liguria (primary) and among the EMCC's call takers in Genoa...
Lee County, Florida, has 108 golf courses. Snowbird season packs the golf courses with many who are older. Medical emergencies: stroke; cardiac arrest; fractures; back injuries; stings; and heat exhaustion are common. Access to patients on golf courses is challenging. Golfers can only see the lanais and back of houses—not street addresses. To design a Graphic Information System (GIS) and Computer Aided Dispatch (CAD) solution to identify patient locations using common place names and verified addresses. GIS produced maps of all 108 courses were labeled with possible access points to...
In a previous study, emergency dispatchers were surveyed to determine how stressful it was to handle various 911 calls. Given that it is not possible to change the inherent stress associated with the job of emergency dispatching, it is important to examine additional strains that contribute to making the job more stressful. This is critical for understanding the risk factors that contribute to the increased rate of stress injuries (i.e., acute stress disorder, posttraumatic stress disorder, burnout) in this high-risk occupation. The current study examined the four calls that the previous study...
A fast response to an emergency call is one of the main objectives of an emergency medical communication center (EMCC). In 2011, a scripted logic-based dispatch protocol system, the Medical Priority Dispatch System™ (MPDS®), was implemented in the five Liguria Region EMCCs in Italy, to manage emergency medical calls. However, response delay time (RD) (i.e., time from when the call rings to when emergency medical dispatcher [EMD] picks it up) and duration of emergency call (DEC) (i.e., time from call pick up to when the call is closed)...
To study the prehospital emergency system guided by MPDS and its effects on improving the treatment level and prognosis of stroke patients. 325 new acute stroke patients who were admitted to emergency department from April 2014 to March 2015 were divided into 2 groups: those rescued by MPDS (n=171), and those that went to the ER by themselves (n=154). The time of first aid, case fatality ratio, complication rate, National Institutes of Health Stroke Scale (NIHSS) and Barthel Index scores were compared between the two groups. Time of admission to the emergency department, case fatality ratio...
Suzhou first aid center began to use the MPDS system in January 1, 2011. This study looked at Suzhou emergency center transports of 641 cases of acute myocardial infarction in patients with a retrospective analysis. The study aims to explore the MPDS in acute myocardial infarction patients to see the effects of the new prehospital treatment. The 641 AMI patients, for whom Suzhou Emergency Center had been involved in their prehospital treatment and transportation from January 2008 to January 2014, were selected for the study. These patients were divided into MPDS Group (389 cases, after Suzhou...
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...
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...
Bystander Cardiopulmonary Resuscitation (CPR) has been recognized as a critical component in the survival of out-of-hospital cardiac arrest (OHCA); likewise, time is a factor in the effectiveness of CPR. Pre-arrival instructions (PAIs) for CPR performance by Emergency Medical Dispatchers (EMDs) increase the rate of bystander CPR and OHCA survival. While uncontrollable barriers to PAIs delivery exists, time to first compression (TTFC) remains a modifiable component of the EMD-caller interaction. To develop a model describing the impact of TTFC intervals of...
Adequate chest compression (CC) depth is paramount for resuscitation outcomes. Elderly rescuers are often unable to achieve the required 5-6 cm CC depth; thus, we investigated new strategies to improve CC performance. To evaluate the effects of the Andrew Maneuver (four-hands CC) on the depth of CCs performed by elderly bystanders in the setting of simulated dispatcher-assisted cardiopulmonary resuscitation (DA-CPR). A randomized controlled trial conducted in December 2013. Sixty-eight lay rescuers aged 50–75 were randomized to intervention or control pairs (males and females separately)...
The job of an emergency dispatcher is inherently stressful. As a 9-1-1 dispatcher, it is expected to receive a call for a multi-system trauma victim, a child drowning, an assault, amongst thousands of others, will be answered. These stressors are encountered multiple times per shift. While answering the call is controllable, the stressor on the other end is not. To examine the relationships of emergency dispatchers' home and work life, and present perceived control (how one focuses energy on what can be controlled in an uncontrollable situation) on secondary traumatic stress (STS), the effects...
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