Medical priority dispatch codes—comparison with National Early Warning Score
Abstract Background In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories—from A (highest risk) to D (lowest risk)—following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leadi...
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ftbiomed:oai:biomedcentral.com:s13049-016-0336-y 2023-05-15T17:42:52+02:00 Medical priority dispatch codes—comparison with National Early Warning Score Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero 2016-12-03 http://www.sjtrem.com/content/24/1/142 en eng BioMed Central Ltd. http://www.sjtrem.com/content/24/1/142 Copyright 2016 The Author(s). Emergency medical services Medical dispatch codes Early warning score Triage Original research 2016 ftbiomed 2016-12-11T00:56:34Z Abstract Background In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories—from A (highest risk) to D (lowest risk)—following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient’s condition assessed by emergency medical services on the scene using an early warning risk assessment tool. Methods Using medical charts, clinical variables were prospectively recorded and evaluated for all emergency medical services missions in two hospital districts in Northern Finland during 1.1.2014–30.6.2014. Risk assessment was then re-categorized as low, medium, or high by calculating the National Early Warning Score (NEWS) based on the patients’ clinical variables measured at the scene. Results A total of 12,729 emergency medical services missions were evaluated, of which 616 (4.8%) were prioritized as A, 3193 (25.1%) as B, 5637 (44.3%) as C, and 3283 (25.8%) as D. Overall, 67.5% of the dispatch missions were correctly estimated according to NEWS. Of the highest dispatch priority missions A and B, 76.9 and 78.3%, respectively, were overestimated. Of the low urgency missions (C and D), 10.7% were underestimated; 32.0% of the patients who were assigned NEWS indicating high risk had initially been classified as low urgency C or D priorities at the dispatch. Discussion and conclusion The present results show that the current Finnish medical dispatch protocol is suboptimal and needs to be further developed. A substantial proportion of EMS missions assessed as highest priority were categorized as lower risk according to the NEWS determined at the scene, indicating over-triage with the protocol. On the other hand, only a quarter of the high risk NEWS patients were classified as the highest priority at dispatch, indicating considerable under-triage with the protocol. Other/Unknown Material Northern Finland BioMed Central |
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English |
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Emergency medical services Medical dispatch codes Early warning score Triage |
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Emergency medical services Medical dispatch codes Early warning score Triage Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero Medical priority dispatch codes—comparison with National Early Warning Score |
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Emergency medical services Medical dispatch codes Early warning score Triage |
description |
Abstract Background In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categories—from A (highest risk) to D (lowest risk)—following a criteria-based national dispatch protocol. Discrepancies in triage may result in risk overestimation, leading to inappropriate use of emergency medical services units and to risk underestimation that can negatively impact patient outcome. To evaluate dispatch protocol accuracy, we assessed association between priority assigned at dispatch and the patient’s condition assessed by emergency medical services on the scene using an early warning risk assessment tool. Methods Using medical charts, clinical variables were prospectively recorded and evaluated for all emergency medical services missions in two hospital districts in Northern Finland during 1.1.2014–30.6.2014. Risk assessment was then re-categorized as low, medium, or high by calculating the National Early Warning Score (NEWS) based on the patients’ clinical variables measured at the scene. Results A total of 12,729 emergency medical services missions were evaluated, of which 616 (4.8%) were prioritized as A, 3193 (25.1%) as B, 5637 (44.3%) as C, and 3283 (25.8%) as D. Overall, 67.5% of the dispatch missions were correctly estimated according to NEWS. Of the highest dispatch priority missions A and B, 76.9 and 78.3%, respectively, were overestimated. Of the low urgency missions (C and D), 10.7% were underestimated; 32.0% of the patients who were assigned NEWS indicating high risk had initially been classified as low urgency C or D priorities at the dispatch. Discussion and conclusion The present results show that the current Finnish medical dispatch protocol is suboptimal and needs to be further developed. A substantial proportion of EMS missions assessed as highest priority were categorized as lower risk according to the NEWS determined at the scene, indicating over-triage with the protocol. On the other hand, only a quarter of the high risk NEWS patients were classified as the highest priority at dispatch, indicating considerable under-triage with the protocol. |
format |
Other/Unknown Material |
author |
Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero |
author_facet |
Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero |
author_sort |
Hoikka, Marko |
title |
Medical priority dispatch codes—comparison with National Early Warning Score |
title_short |
Medical priority dispatch codes—comparison with National Early Warning Score |
title_full |
Medical priority dispatch codes—comparison with National Early Warning Score |
title_fullStr |
Medical priority dispatch codes—comparison with National Early Warning Score |
title_full_unstemmed |
Medical priority dispatch codes—comparison with National Early Warning Score |
title_sort |
medical priority dispatch codes—comparison with national early warning score |
publisher |
BioMed Central Ltd. |
publishDate |
2016 |
url |
http://www.sjtrem.com/content/24/1/142 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_relation |
http://www.sjtrem.com/content/24/1/142 |
op_rights |
Copyright 2016 The Author(s). |
_version_ |
1766144786127912960 |