Medical priority dispatch codes-comparison with National Early Warning Score
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 in...
Published in: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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ftunivhelsihelda:oai:helda.helsinki.fi:10138/174089 2024-01-07T09:45:29+01:00 Medical priority dispatch codes-comparison with National Early Warning Score Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero I. Clinicum Department of Diagnostics and Therapeutics Anestesiologian yksikkö 2017-01-26T08:36:01Z 7 application/pdf http://hdl.handle.net/10138/174089 eng eng BMC 10.1186/s13049-016-0336-y The study was funded by Oulu University Hospital EVO grant. Hoikka , M , Länkimäki , S , Silfvast , T & Ala-Kokko , T I 2016 , ' Medical priority dispatch codes-comparison with National Early Warning Score ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 24 , 142 . https://doi.org/10.1186/s13049-016-0336-y 85001033129 74136845-af26-4a38-bf44-05b5ddcddccc http://hdl.handle.net/10138/174089 000391140800002 cc_by openAccess info:eu-repo/semantics/openAccess Emergency medical services Medical dispatch codes Early warning score Triage SYSTEM PERFORMANCE AMBULANCE ABILITY 3126 Surgery anesthesiology intensive care radiology Article publishedVersion 2017 ftunivhelsihelda 2023-12-14T00:15:42Z 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 ... Article in Journal/Newspaper Northern Finland HELDA – University of Helsinki Open Repository Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 24 1 |
institution |
Open Polar |
collection |
HELDA – University of Helsinki Open Repository |
op_collection_id |
ftunivhelsihelda |
language |
English |
topic |
Emergency medical services Medical dispatch codes Early warning score Triage SYSTEM PERFORMANCE AMBULANCE ABILITY 3126 Surgery anesthesiology intensive care radiology |
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Emergency medical services Medical dispatch codes Early warning score Triage SYSTEM PERFORMANCE AMBULANCE ABILITY 3126 Surgery anesthesiology intensive care radiology Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero I. Medical priority dispatch codes-comparison with National Early Warning Score |
topic_facet |
Emergency medical services Medical dispatch codes Early warning score Triage SYSTEM PERFORMANCE AMBULANCE ABILITY 3126 Surgery anesthesiology intensive care radiology |
description |
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 ... |
author2 |
Clinicum Department of Diagnostics and Therapeutics Anestesiologian yksikkö |
format |
Article in Journal/Newspaper |
author |
Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero I. |
author_facet |
Hoikka, Marko Länkimäki, Sami Silfvast, Tom Ala-Kokko, Tero I. |
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 |
BMC |
publishDate |
2017 |
url |
http://hdl.handle.net/10138/174089 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_relation |
10.1186/s13049-016-0336-y The study was funded by Oulu University Hospital EVO grant. Hoikka , M , Länkimäki , S , Silfvast , T & Ala-Kokko , T I 2016 , ' Medical priority dispatch codes-comparison with National Early Warning Score ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 24 , 142 . https://doi.org/10.1186/s13049-016-0336-y 85001033129 74136845-af26-4a38-bf44-05b5ddcddccc http://hdl.handle.net/10138/174089 000391140800002 |
op_rights |
cc_by openAccess info:eu-repo/semantics/openAccess |
container_title |
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
container_volume |
24 |
container_issue |
1 |
_version_ |
1787427025217126400 |