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Abstract

Introduction: Extrication activities at the scene of motor vehicle accidents (MVA) result in extended scene times, and increase morbidity and mortality. Identifying the need for extrication-capable resources during the 9-1-1 call-taking process, and dispatching them without delay, is crucial to delivering the required response and patient care.  Determining the need for extrication using this protocol currently relies on the 9-1-1 caller’s answer to a single key question in the protocol: “Is anyone pinned (trapped)?”

Objectives: The aims of this study were to determine the predictive value of the single key question; to evaluate the predictive value of limited mode of injury factors in extrication; and to validate the need to reconfigure the protocol to include additional suffixes for mechanism of injury that would likely account for extrication activities.

Methods: This was a retrospective descriptive study of all MVA cases in three Kansas counties (Butler, Sedgwick, and Johnson), encountered from January 1, 2016, through June 30, 2017. 9-1-1 calltakers in the study population utilize the Medical Priority Dispatch System (MPDS®) Protocols (Priority Dispatch, Salt Lake City, Utah, USA) to triage calls. Traffic accident data was extracted from ProQA and CAD databases.

Results: A total of 985 calls were analyzed, of which 218 (22.1%) required extrication and 267 (27.1%) involved semi/head-on—as documented by responders. Of the 218 cases that required extrication, 121 (55.5%) were reported pinned at dispatch and 21 (9.6%) involved SEMI/head-on—15 (71.4%) of which were already captured by the pinned Key Question.  Of the 267 semi/head-on involvement cases, 21 (7.9%) required extrication.

Conclusions: The protocol key question “is anyone pinned (trapped)?” is a better predictor of extrication activity at injury MVAs compared to SEMI/head-on involvement. Further research should examine whether High Mechanism and Major Incident determinant suffixes will capture additional extrication incidents.

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