| 1. |
- Carlström, Eric, et al.
(författare)
-
The Second Opinion Dispatch- Evaluating Decisions Made by an Ambulance Dispatch Center
- 2017
-
Ingår i: Global Journal of Health Science. - : Canadian Center of Science and Education. - 1916-9736 .- 1916-9744. ; 9:12, s. 107-113
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The efficacy and precision of dispatching right ambulance to right patient demands a proper decision-making. Wrong decisions may lead to overloading of emergency departments and shortage of ambulances. The aim of this study was to evaluate and improve the process of prehospital resource allocation conducted by a Swedish ambulance dispatch center. METHODS: A team of three experienced ambulance and dispatch nurses evaluated the decisions made by the dispatch center. The method chosen was “Action Research” divided into five actions during 76 days. In the first action, the team listened passively to the calls. The team gradually increased its involvement in the process of decision-making during the actions. RESULTS: During the actions, specific keywords indicating a need for evaluation were identified. The results showed a need to change the primary decisions in 486 cases out of 24,800 calls (2%). The most common measure after an evaluation was to change an ordinary ambulance transportation to an assessment vehicle staffed by a nurse or a physician who would select an appropriate care level (hospital vs. primary healthcare). CONCLUSION: This model not only optimized the prehospital resources but also changed the process of decision-making at the dispatch center and improved their staffs’ ability to optimize the allocation of emergency resources.
|
|
| 3. |
- Wennman, Ingela, et al.
(författare)
-
The clinical consequences of a pre-hospital diagnosis of stroke by the emergency medical service system. A pilot study.
- 2012
-
Ingår i: Scandinavian journal of trauma, resuscitation and emergency medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 20
-
Tidskriftsartikel (refereegranskat)abstract
- There is still a considerable delay between the onset of symptoms and arrival at a stroke unit for most patients with acute stroke.The aim of the study was to describe the feasibility of a pre-hospital diagnosis of stroke by an emergency medical service (EMS) nurse in terms of diagnostic accuracy and delay from dialing 112 until arrival at a stroke unit.Between September 2008 and November 2009, a subset of patients with presumed acute stroke in the pre-hospital setting were admitted by EMS staff directly to a stroke unit, bypassing the emergency department. A control group, matched for a number of background variables, was created.In all, there were 53 patients in the direct admission group, and 49 patients in the control group. The median delay from calling for an ambulance until arrival at a stroke unit was 54 minutes in the direct admission group and 289 minutes in the control group (p < 0.0001).In a comparison between the direct admission group and the control group, a final diagnosis of stroke, transient ischemic attack (TIA) or the sequelae of prior stroke was found in 85% versus 90% (NS). Among stroke patients who lived at home prior to the event, the percentage of patients that were living at home after 3 months was 71% and 62% respectively (NS).In a pilot study, the concept of a pre-hospital diagnosis of stroke by an EMS nurse was associated with relatively high diagnostic accuracy in terms of stroke-related diagnoses and a short delay to arrival at a stroke unit. These data need to be confirmed in larger studies, with a concomitant evaluation of the clinical consequences and, if possible, the level of patient satisfaction as well.
|
|
