BackgroundEmergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical services (EMS) crews identified the same first aid measures as indicated.MethodsFor 18 months, the crew on the first EMS crew responding to trauma calls used a standard form to assess bystander first aid. Audio recordings of the corresponding telephone calls from bystanders to the EMCC were reviewed.ResultsA total of 311 trauma calls were included. The on-scene EMS crew identified needs for the following first-aid measures: free airway in 26 patients, CPR in 6 patients, and hypothermia prevention in 179 patients. EMCC dispatchers advised these measures, respectively, in 16 (62%), 5 (83%), and 54 (30%) of these cases. Dispatcher guidance was not correlated with correctly performed bystander first aid. For potentially life saving first aid measures, all (20/20) callers who received dispatcher guidance attempted first aid, while only some few (4/22) of the callers who did not receive dispatcher guidance did not attempt first aid.DiscussionOverall, the EMCC dispatchers had low sensitivity and specificity for correctly identifying trauma patients requiring first-aid measures. Dispatcher guidance did not significantly influence whether on-scene bystander first aid was performed correctly or attempted in this study setting, with a remarkably high willingness to perform first-aid. However, the findings for potentially lifesaving measures suggests that there may be differences that this study was unable to detect.ConclusionThis study found a high rate of first-aid willingness and performance, even without dispatcher prompting, and a low precision in dispatcher advice. This underlines the need for further knowledge about how to increase EMCC dispatchers’ possibility to identify trauma patients in need of first aid. The correlation between EMCC-guidance and bystander first aid should be investigated in study settings with lower spontaneous first-aid rates.
Background Early cardiopulmonary resuscitation (CPR) and use of an automated external defibrillator (AED) can increase 30-day survival from 10% up to 70%. An unmanned aerial vehicle (UAV) might have a role in transporting an AED to the site of an OHCA. The aim of this experimental study was to describe the potential benefit of an UAV system for delivery of an AED in a rural environment. Materials and methods Optimal placement and response times for AED equipped UAV were calculated using GIS-models based on two weighting alternatives. UAV delivery testflights were performed using three different techniques. Results All OHCA cases with a cardiac aetiology n = 7923 in Stockholm county 2006-2013 were analyzed. Ten optimal locations with a 10 km radius in the greater Stockholm area were identified for implementation of UAV systems. With a simulated 50/50 weighting n = 7905 cases were found primarily in the city centre. The UAV arrived before EMS in 32% of cases with a mean timesaving of 1.5 min. With a simulated 80/20 weighting including n = 134 OHCA cases in primarily remote areas, the UAV arrived before EMS in 93% of cases with a mean timesaving of 19 min. Delivery of the AED in testflights n = 14 was successful in favourable conditions within sight primarily by latch-released technique or by landing the UAV on flat ground. Conclusions By using GIS models optimal placement of UAV systems can be calculated. These locations might in the future significantly reduce time to defibrillation and serve as a complement to EMS services. A4 Prehospital patient safety incidentsa description based on a national mandatory reporting system
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