scholarly journals Registered nurses’ understandings of emergency medical dispatch centre work ‐ A qualitative phenomenographic interview study

2021 ◽  
Author(s):  
Elenor Kaminsky ◽  
Ylva Lindberg ◽  
Douglas Spangler ◽  
Ulrika Winblad ◽  
Inger Holmström
Keyword(s):  
Registered Nurses ◽  
Interview Study ◽  
Emergency Medical Dispatch ◽  
Emergency Medical ◽  
Dispatch Centre

scholarly journals The perspectives of Swedish registered nurses about managing difficult calls to emergency medical dispatch centres: a qualitative descriptive study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Inger K. Holmström ◽  
Elenor Kaminsky ◽  
Ylva Lindberg ◽  
Douglas Spangler ◽  
Ulrika Winblad
Keyword(s):  
Registered Nurses ◽  
Visual Cues ◽  
Time Pressure ◽  
Emergency Medical Dispatch ◽  
Individual Interviews ◽  
Emergency Medical ◽  
Life Threatening ◽  
Qualitative Descriptive ◽  
The Right ◽  
And Coping

Abstract Background Telephone triage at emergency medical dispatch centres is often challenging for registered nurses due to lack of visual cues, lack of knowledge about the patient, and time pressure – and making the right decision can be a matter of life and death. Some calls may be more difficult to handle, and more knowledge is needed about these calls to develop education and coping strategies. Therefore, the aim of this study was to describe the perspectives of registered nurses’ views about managing difficult calls to emergency medical dispatch centres. Methods A descriptive design with a qualitative inductive approach was used. Three dispatch centers in mid-Sweden were investigated, covering about 950,000 inhabitants and handling around 114,000 calls per year. Individual interviews were carried out with a purposeful sample of 24 registered nurses. Systematic text condensation was conducted. Results Seven themes were generated: calls with communication barriers, calls from agitated or rude callers, calls about psychiatric illness, calls from third parties, calls about rare or unclear situations, calls with unknown addresses and calls regarding immediate life-threatening conditions. There was a strong consensus among the registered nurses about which calls were experienced as difficult, with the exception of calls about immediate life-threatening conditions. Some registered nurses thought calls about immediate life-threatening conditions were easy to handle as they simply adhered to protocol, while others described these calls as difficult and were emotionally affected. Conclusion The registered nurses’ descriptions of difficult calls focused on the callers, while their own role, the organisational framework, and leadership were not mentioned. Many types of calls included difficulties, which could be related to the caller, their symptoms, or different circumstances. The registered nurses pointed to language barriers and rude, agitated callers as increasing problems. An investigation of actual emergency calls is warranted to examine the extent and nature of such calls.

scholarly journals Impact of a visual indicator on the noise level in an emergency medical dispatch centre - a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Justin Outrey ◽  
Jean-Baptiste Pretalli ◽  
Sophie Pujol ◽  
Alice Brembilla ◽  
Thibaut Desmettre ◽  
...  
Keyword(s):  
Noise Level ◽  
Ambient Noise ◽  
Visual Noise ◽  
Noise Levels ◽  
Emergency Medical Dispatch ◽  
Baseline Phase ◽  
Ambient Noise Level ◽  
Emergency Medical ◽  
Dispatch Centre ◽  
The Impact

Abstract Background Noise levels are monitored in call centres. A maximum of 52 to 55 dB(A) is recommended in order to prevent adverse events. We aimed at assessing the noise level and the impact of a visual noise indicator on the ambient noise level in a French Regional Emergency Medical Dispatch Centre (EMDC). Methods We conducted an observational study in the EMDC of the SAMU25 (University Hospital of Besancon). We measured the noise level using a SoundEarII® noise indicator (Dräger Medical SAS, France). The measurement took place in two phases on three consecutive days from 00:00 to 11:59 PM. At baseline, phase 1, the device recorded the average ambient noise for each minute without visual indication. Secondly, phase 2 included a sensor mounted with a light that would turn on green if noise was below 65 dB(A), orange if noise ever exceeded 65 and red if it exceeded 75 dB(A). Results In the presence of the visual noise indicator, the LAeq was significantly lower than in the absence of visual noise indicator (a mean difference of − 4.19 dB; P < 10–3). It was higher than 55 dB(A) in 84.9 and 43.9% of the time in phases 1 and 2, respectively. Conclusions The noise levels were frequently higher than the standards, and sometimes close to recommended limits, requiring preventive measures. The noise indicator had a positive effect on the ambient noise level. This work will allow the implementation of effective prevention solutions and, based on future assessments, could improve operators’ well-being and better care for patient.

scholarly journals Outpatient care in acute and prehospital emergency medicine by emergency medical and patient transport service over a 10-year period: a retrospective study based on dispatch data from a German emergency medical dispatch centre (OFF-RESCUE)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marc S. Schehadat ◽  
Guido Scherer ◽  
David A. Groneberg ◽  
Manfred Kaps ◽  
Michael H. K. Bendels
Keyword(s):  
Emergency Medical Service ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Service ◽  
Transport Service ◽  
Emergency Medical Dispatch ◽  
Economic Point ◽  
Patient Transport ◽  
Emergency Medical ◽  
Dispatch Centre

Abstract Background The number of operations by the German emergency medical service almost doubled between 1994 and 2016. The associated expenses increased by 380% in a similar period. Operations with treatment on-site, which retrospectively proved to be misallocated (OFF-Missions), have a substantial proportion of the assignment of the emergency medical service (EMS). Besides OFF-Missions, operations with patient transport play a dominant role (named as ON-Missions). The aim of this study is to work out the medical and economic relevance of both operation types. Methods This analysis examined N = 819,780 missions of the EMS and patient transport service (PTS) in the catchment area of the emergency medical dispatch centre (EMDC) Bad Kreuznach over the period from 01/01/2007 to 12/31/2016 in terms of triage and disposition, urban-rural distribution, duration of operations and economic relevance (p < .01). Results 53.4% of ON-Missions are triaged with the indication non-life-threatening patient transport; however, 63.7% are processed by the devices of the EMS. Within the OFF-Mission cohort, 78.2 and 85.8% are triaged or dispatched for the EMS. 74% of all ON-Missions are located in urban areas, 26% in rural areas; 81.3% of rural operations are performed by the EMS. 66% of OFF-Missions are in cities. 93.2% of the remaining 34% of operations in rural locations are also performed by the EMS. The odds for both ON- and OFF-Missions in rural areas are significantly higher than for PTS (ORON 3.6, 95% CI 3.21–3.30; OROFF 3.18, 95% CI 3.04–3.32). OFF-Missions last 47.2 min (SD 42.3; CI 46.9–47.4), while ON-Missions are processed after 79.7 min on average (SD 47.6; CI 79.6–79.9). ON-Missions generated a turnover of more than € 114 million, while OFF-Missions made a loss of almost € 13 million. Conclusions This study particularly highlights the increasing utilization of emergency devices; especially in OFF-Missions, the resources of the EMS have a higher number of operations than PTS. OFF-Missions cause immensely high costs due to misallocations from an economic point of view. Appropriate patient management appears necessary from both medical and economic perspective, which requires multiple solution approaches.

scholarly journals The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system

CJEM ◽  
2015 ◽  
Vol 17 (4) ◽  
pp. 411-419 ◽  
Author(s):  
Alberto Mortaro ◽  
Diana Pascu ◽  
Tamara Zerman ◽  
Enrico Vallaperta ◽  
Alberto Schönsberg ◽  
...  
Keyword(s):  
Emergency Care ◽  
Prehospital Care ◽  
Prehospital Setting ◽  
Prehospital Emergency Care ◽  
Incident Report ◽  
Emergency Medical Dispatch ◽  
Emergency Medical ◽  
Dispatch Centre ◽  
Prehospital Emergency

AbstractIntroductionThe role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives.MethodsAn ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010.ResultsDuring the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population.ConclusionsDespite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a “learning organization” and improve both efficacy and safety of first aid care.

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