1/19/2024 0 Comments Medical priority system![]() ![]() The objective of the current systematic review was to examine the evidence, according to GRADE, for medical dispatching systems to accurately dispatch EMS according to level of acuity and in recognition of specific conditions. There is, however, no consensus on levels for over-and under-triage or dispatching accuracy. to avoid under-triage, over-triage consumes resources and increases the risk for occupational injuries of health care personnel. While our systems are geared towards over-triage so as not to miss critical patients in need of medical interventions, i.e. Other relevant measures of performance of dispatching systems are over- and under-triage. positive predictive value and negative predictive value. sensitivity and specificity, and predictive, e.g. Measures of accuracy are both discriminative, e.g. However, the accuracy of EMS systems, which per definition includes both dispatching and the response to dispatching are not systematically described.ĭispatching accuracy, or effectiveness, relates to the ability of the dispatching system to discriminate between the required EMS resources and the priority of these. advanced and/or basic life support ambulances, first responders or pre-hospital emergency physicians and helicopter emergency services (HEMS). In addition to the different systems for medical dispatching, there are also different systems for the EMS response. While MPDS is based on codes and scripted questions to put to the caller, the CBD system relies on the experience of the telecommunicator to conduct the interview. Common for both systems is that the telecommunicator allocates each call to one of the listed chief complaints. There are several types of dispatching systems but they can be categorized as two types of systems the Medical Priority Dispatch system (MPDS) mainly used in Anglo-Saxon countries, and the criteria-based dispatch (CBD) used in Nordic and European countries. The challenge is to dispatch EMS appropriately with limited resources and still be safe for the patients this requires accurate dispatching systems. The objective for the telecommunicator at the dispatch center is - based on the information obtained during a telephone call – to evaluate whether emergency medical services (EMS) are needed and with which priority the resource needs to be dispatched. We suggest that it is necessary to create a consensus on common standards for reporting before consensus can be reached for the level of accuracy in medical dispatching systems. The results of the current review show that there is a very low to low overall level of evidence for the accuracy of medical dispatching systems. The 18 articles addressed the identification of cardiac arrest, stroke, medical priority and major trauma using different dispatching systems. The current review included 18 publications which all were based on primary research. An additional five articles were excluded after review of the full text versions of the remaining articles. After the removal of duplicates, 382 titles were reviewed for relevance and an additional 359 articles were excluded based on manuscript title and abstract. sensitivity, specificity, positive and negative predictive and/or over- and under-triage. Articles included were those that provided evidence for at least one of the measures of dispatch system accuracy i.e. Level of evidence was evaluated in accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Publications were included according to the inclusion/exclusion criteria using the Systematic Reviews and Meta-Analyses (PRISMA) protocol. A combination of keywords and Medical Subject Heading (MeSH) terms relevant to “emergency medical dispatch criteria” were used, to search for articles published between 20. The objective of the current systematic review was to examine the evidence, according to GRADE, for medical dispatching systems to accurately dispatch EMS according to level of acuity and in recognition of specific conditions.Ī systematic search was performed trough PubMed, Web of Science, Embase (free text in all fields), Centre for Reviews and Dissemination (CRD), and Cochrane Central Register of Controlled Trials up to 16th of May, 2017. It is a challenge to dispatch Emergency medical Services (EMS) appropriately with limited resources and maintaining patient safety this requires accurate dispatching systems. ![]()
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