At first glance, the pieces in this issue of AEDR may not seem to have much in common. A statistician’s notes on the challenges of Big Data? A discussion of vehicles trapped in rising floodwaters? A review of the words and phrases that most often signal stroke? What could all of these things possibly have to do with one another? In terms of topic, not much; but in the bigger picture, these pieces have something much more important in common. They signal a sea change in dispatch research, a shift from a narrow focus on one or two critical incident types (mostly medical, mostly cardiac arrest-related) to a broad, and broadly relevant, field of study.
After all, dispatching as a practice has never been primarily focused on cardiac arrest; far from it. As our readers know, dispatchers handle dozens—even hundreds—of types of calls, including everything from fire emergencies and rescues to barking dogs and broken legs. This is not to say that cardiac arrest, chest pain, and the other heavily-studied domains of dispatch science are not important. Rather, what we are seeing now is a much-needed expansion of the reach of dispatch science to include the whole scope of what dispatchers do, and the knowledge needed to do it right.
To that end, we are seeing a movement toward the study of other high-acuity conditions in which time matters, such as stroke. For example, in this issue we have included two papers on stroke that are very different in methodology, yet similar in their attempts to improve the identification of stroke at the dispatch point. Stroke may be less immediately life-threatening than cardiac arrest, but it can be deadly. Perhaps more importantly, stroke is far more variable than cardiac arrest. Strokes may present with different symptoms in different people. These symptoms may come and go, or they may disappear for hours, days, or weeks (as in a transient ischemic attack, or TIA), only to come back later as a full-fledged stroke. Moreover, compared to cardiac arrest, stroke is highly treatable—as long as treatment is administered quickly. This is the kind of condition, in other words, for which dispatch identification can be critically important.
In the spirit of expanding the scope of dispatch science, we are also seeing an increased emphasis on studies outside the realm of medicine. This issue contributes to the trend, including an analysis of the time it takes to gather accurate scene information to dispatch the appropriate response in structure fires, as well as a discussion of the evidence base behind a new protocol for handling vehicles stranded in rising floodwaters.
In addition, we are happy to present a collection of smaller pieces that reflect the growing diversity of methods and topics in dispatch science, including a brief discussion of the potential challenges presented by Big Data as dispatch practice and science grow to accommodate increasing populations. Similarly, the abstracts collected at the end of the issue (a selection of those presented at Navigator 2016) reflect the new diversity of work, including a discourse analysis of calls making use of a language line, a number of studies evaluating different measures of effectiveness in dispatching, and the results of a survey on the most stressful types of calls handled by dispatchers.
In the end, though, the best indicator of the increasing scope of dispatch science is its increased reach across the globe. Represented in this issue alone are researchers and dispatch professionals from Italy, Australia, Canada, India, China, and the U.S. We are excited to be part of this joint movement to foster evidence-based emergency dispatch worldwide.
Isabel Gardett, PhD