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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ftdatacite:10.6084/m9.figshare.c.3610640 2023-05-15T17:42:54+02:00 Medical priority dispatch codes—comparison with National Early Warning Score Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero 2016 https://dx.doi.org/10.6084/m9.figshare.c.3610640 https://figshare.com/collections/Medical_priority_dispatch_codes_comparison_with_National_Early_Warning_Score/3610640 unknown Figshare https://dx.doi.org/10.1186/s13049-016-0336-y CC BY 4.0 https://creativecommons.org/licenses/by/4.0 CC-BY Medicine Pharmacology Biotechnology Ecology FOS Biological sciences Sociology FOS Sociology 111714 Mental Health FOS Health sciences 110309 Infectious Diseases Plant Biology Collection article 2016 ftdatacite https://doi.org/10.6084/m9.figshare.c.3610640 https://doi.org/10.1186/s13049-016-0336-y 2021-11-05T12:55:41Z 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. Article in Journal/Newspaper Northern Finland DataCite Metadata Store (German National Library of Science and Technology) |
institution |
Open Polar |
collection |
DataCite Metadata Store (German National Library of Science and Technology) |
op_collection_id |
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unknown |
topic |
Medicine Pharmacology Biotechnology Ecology FOS Biological sciences Sociology FOS Sociology 111714 Mental Health FOS Health sciences 110309 Infectious Diseases Plant Biology |
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Medicine Pharmacology Biotechnology Ecology FOS Biological sciences Sociology FOS Sociology 111714 Mental Health FOS Health sciences 110309 Infectious Diseases Plant Biology Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero Medical priority dispatch codes—comparison with National Early Warning Score |
topic_facet |
Medicine Pharmacology Biotechnology Ecology FOS Biological sciences Sociology FOS Sociology 111714 Mental Health FOS Health sciences 110309 Infectious Diseases Plant Biology |
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 |
Article in Journal/Newspaper |
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 |
Figshare |
publishDate |
2016 |
url |
https://dx.doi.org/10.6084/m9.figshare.c.3610640 https://figshare.com/collections/Medical_priority_dispatch_codes_comparison_with_National_Early_Warning_Score/3610640 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_relation |
https://dx.doi.org/10.1186/s13049-016-0336-y |
op_rights |
CC BY 4.0 https://creativecommons.org/licenses/by/4.0 |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.6084/m9.figshare.c.3610640 https://doi.org/10.1186/s13049-016-0336-y |
_version_ |
1766144832742359040 |