Evidence-based medicine (sometimes called scientific medicine) has existed in some form since at least the 16th century, when Andreus Vesalius, the "father of human anatomy," published diagrams of the human body actually based on anatomical investigation. William Harvey's publication of the first accurate description of the cardiovascular system, the 1665 discovery of the cell by Robert Hooke, and the 19th-century revelation of the neuron as the basic unit of the brain were also critical milestones. In the 1960s, the push toward evidence-based medicine became stronger, and basic science research began to find its way more often into the clinic, leading finally to a modern medical practice that is steeped in scientific evidence.
Now, with the advent of Annals of Emergency Dispatch & Response (AEDR) and the dedicated work of the researchers whose papers we publish, emergency dispatching is beginning to find its place in that history. The papers in this issue, although they originate from around the world, all contribute powerfully to the argument for evidence-based practice in dispatching.
Interestingly, the research here does not focus only on the immediate practice of answering 911 calls, but on the broader system that enables timely, efficient response to emergency situations. One paper investigates, for example, the causes and possible mitigators of stress in 911 dispatchers, providing evidence for possible interventions to reduce stress-related problems in the dispatch center. Another looks at seizures in a rural area in India, demonstrating that improved access to prehospital care could significantly improve treatment for seizure patients in that area.
Several papers also address evidence-based resource utilization. One looks at the use of the Obvious and Expected Death Protocol, demonstrating that dispatchers' ability to accurately identify unquestionable deaths is so high that the findings could lead to more appropriate distribution and utilization of the scarce response units equipped to handle potentially salvageable cardiac arrests. Another examines two locations using the Emergency Communication Nurse System nurse triage system, demonstrating that the value of the system is high enough that it is actually overwhelming demand. The study concludes that allocating new resources, and expanding time of use, could potentially produce significant savings without affecting quality of care.
These are just some of the impressive studies presented in this issue from all over the world. All of the work here is fascinating in its own right, but as you read, remember also that these studies represent some of the first, and most important, steps for dispatch into the world of true evidence-based practice. It's an exciting time to be in dispatching-and we're glad you can share it with us.
Isabel Gardett, PhD