In medical emergencies involving out-of-hospital cardiac arrests (OHCAs), bystanders reasonably, but sometimes incorrectly, expect that a call to 911 will result in a dispatcher guiding the caller through the steps of cardiopulmonary resuscitation (CPR). The primary objective of this research is to investigate the role of the dispatcher and dispatcher-assisted telephone-CPR (TCPR) in survival rates of OHCAs. This naturally led to an evaluation of the data collection practices of public safety answering points (PSAPs), emergency medical service (EMS) and fire departments, and hospitals for...
Opioid overdose is the leading cause of accidental death in the US. To respond to this public health crisis, public health and safety agencies are attempting to optimize their use of data sets that can identify opioid overdoses cases early in the continuum of emergency medical care. In this study, we are developing and validating a novel approach to identifying opioid overdose cases using a set of indicators from pre-hospital data, including the electronic patient care record (ePCR), call taking, and dispatch data. We queried all medical emergency calls in calendar year (CY) 2016 for a single...
Extrication activities at the scene of motor vehicle accidents (MVA) result in extended scene times, and increase morbidity and mortality. Identifying the need for extrication-capable resources during the 9-1-1 call-taking process, and dispatching them without delay, is crucial to delivering the required response and patient care. Determining the need for extrication using this protocol currently relies on the 9-1-1 caller's answer to a single key question in the protocol: "Is anyone pinned (trapped)?" The aims of this study were to determine the predictive value of the single key question...
The manner in which calls are handled at the emergency telecommunication center has a significant role in effective management of assistance on the scene. The main information needed to start a response is the location of the incident, which usually means the complete address. The Genova 118 Center has recently modified its standard greeting from "Genova 118" (STD1) to "Genova 118, where do I send the ambulance?" (STD2). The aim of this study is to verify whether the new standard reduces the time needed to acquire a complete address during an emergency call. The prospective, randomized study...
The main objective of this study was to compare emergency medical dispatch (EMD) stroke identification with hospital-confirmed stroke. The secondary objective was to compare the results of stroke diagnostic tool (SDxT) of Medical Priority Dispatch System™ (MPDS®) with National Institutes of Health Stroke Scale (NIHSS) used in hospital by neurologists. Data utilized for the observational study were taken from a preliminary stroke dataset collected at San Martino Hospital (Genova) between January 2016 and June 2017. All cases of suspected stroke arrived at First Aid began part of the study...
On July 29, 1991 the 91/396/CEE European Community introduced the short number 1-1-2, as the only one European emergency number (EEN). In Italy, the implementation of European Decision began with the legislative decree of August 1st, 2003, and subsequent amendments and additions. In Liguria, Italy, the signing of Memorandum of Understanding between Liguria Region President and Interior Ministry in September 2016, initiated the EEN planning. Purpose of this work is to explain how EEN has been developed in Liguria, which hosts a population of about 1,600,000 with a significant tourist flow that...
On February 14, 2017, the Region of Liguria (one of the 20 regions of Italy) activated a first level public safety answering point that uses the universal European Emergency Number (EEN), 1-1-2. This implementation had 3 primary purposes: immediate call pickup/answering for all emergency calls; a fast call transfer to a secondary PSAP - either medical, police or fire; and filtering of inappropriate calls. This study reports on several performance indicators for the first year of system use. The objective of this study was to report on several key performance indicators of the new system...
In April, 2014 MEDIC Emergency Medical Services (MEDIC EMS) began activation of call-taker initiated activation of stroke alerts based off of the Stroke Diagnostic Tool on Protocol 28 (Stroke [CVA/Transient Ischemic Attack [TIA])—a tool in the Medical Priority Dispatch System™ (MPDS®) (Version 13, 2016, Priority Dispatch Corp., Salt Lake City, UT, USA). Stroke alerts are sent to the local stroke certified receiving facilities and then to the responding ambulance of the MPDS stroke Determinant Code. Once clear evidence of a stroke (Suffix J) is determined, call takers advise local...
In emergency dispatching, pre-alerts are used to send responders to calls prior to getting a final dispatch code—assigned using an emergency dispatch system. Although this dispatching process has been used for several years, no research studies have demonstrated its significant benefit, in general. However, a study published in 2013, showed that pre-alerts can be effectively used to reduce dispatch time for out-of-hospital cardiac arrests (OHCAs), which has the potential to improve overall patient outcome. As emergency calls are received, the call is entered in the Computer Aided Dispatch...
Historically, emergency medical dispatchers (EMDs) do not normally have the opportunity to learn about the outcomes of the patients who they have impacted. More often than not, ST-Elevation Myocardial Infarction (STEMI) cases are urgently transported and triaged within the hospital system, and dispatchers are not afforded the opportunity to learn "the rest of the story" about the patient's outcomes. This leaves the EMDs wondering about the patient, not only from a survival standpoint, but also as to whether or not their pre-arrival instructions (PAIs) made an impact on the patient's condition...
For years, rising EMS call volumes have taxed resources in EMS jurisdictions. A significant problem of utilization by frequent 911 callers has contributed to transports and ED utilization, some of which may be unnecessary. Solutions to this have been limited for field providers. Purpose: We wished to both pilot a new EMS partnership with our county's Health and Human Services Agency (HHS) that could intervene with services for these "super-users," and study the scope of the problem, with the goal being appropriate alternate dispositions besides EMS activation. Intervention through referrals...
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