Prehospital triage accuracy in a criteria based dispatch centre.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_867AF703C665
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prehospital triage accuracy in a criteria based dispatch centre.
Journal
Bmc Emergency Medicine
Author(s)
Dami F., Golay C., Pasquier M., Fuchs V., Carron P.N., Hugli O.
ISSN
1471-227X (Electronic)
ISSN-L
1471-227X
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
15
Pages
32
Language
english
Abstract
BACKGROUND: Priority dispatch accuracy is a key issue in optimizing the match between patients' medical needs and pre-hospital resources. This study measures the accuracy of a Criteria Based Dispatch (CBD) system, by evaluating discrepancies between dispatch priorities and ambulance crews' severity evaluations.
METHODS: This is a retrospective study conducted from January 2011 to December 2011. We ruled that a National Advisory Committee for Aeronautics (NACA) score > 3 (injuries/diseases which can possibly lead to deterioration of vital signs) to 7 (lethal injuries/ diseases) should require a priority dispatch with lights and siren (L&S), while NACA scores < 4 should require a priority dispatch without L&S. Over triage was defined as the proportion of L&S dispatches with a NACA score < 4, and under triage as the proportion of dispatches without L&S with a NACA score > 3.
RESULTS: There were 29,008 primary missions in 2011, 1122 were excluded. Of the 15,749 L&S missions, 12,333 patients had a NACA score < 4, leading to an over triage rate of 78 %; 561 missions out of 12,137 missions without L&S had a NACA score > 3, leading to an under triage rate of 4.6 %. Sensitivity was 86 % (95 % confidence interval: 85.6-86.4 %), specificity 48 % (47.4-48.6 %), positive predictive value 21.7 % (21.2-22.2 %), and negative predictive value 95.4 % (95.2-95.6 %).
CONCLUSION: The rates of over triage and under triage in our CBD are 78 and 4.6 % respectively. The lack of consistent or universal metrics is perhaps the most important limitation in dispatch accuracy research. This is mainly due to the large heterogeneity of dispatch systems and prehospital emergency system.
Pubmed
Open Access
Yes
Create date
21/06/2016 19:23
Last modification date
20/08/2019 14:45
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