A novel method of non-clinical dispatch is associated with a higher rate of critical Helicopter Emergency Medical Service intervention

Munro, Scott; Joy, Mark; Coverly, Richard de; Salmon, Mark; Williams, Julia; Lyon, Richard

doi:10.1186/s13049-018-0551-9

Cited by 25 publications

(33 citation statements)

References 17 publications

(23 reference statements)

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“…The remaining incidents were mainly described as "stroke", "hypoglycaemia" or "general collapse". As expected, the mean time from 112/999 call to arrival of the HEMS crew on scene was longer for crew requests compared to direct dispatch (14 [8][9][10][11][12][13][14][15][16][17][18][19] vs 39 [35-44] min, p < .001) ( Table 1). Table 2 shows the patient characteristics of patients with unexplained LOC attended by HEMS stratified by type of dispatch.…”

Section: Hems Dispatchsupporting

confidence: 68%

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Mohindru¹,

Griggs²,

Coverly³

et al. 2020

BMC Emerg Med

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Background Sudden loss of consciousness (LOC) in the prehospital setting in the absence of cardiac arrest and seizure activity may be a challenge from a dispatcher’s perspective: The aetiology is varied, with many causes being transient and mostly self-limiting, whereas other causes are potentially life threatening. In this study we aim to evaluate the dispatch of HEMS to patients with LOC of medical origin, by exploring to which patients with a LOC HEMS is dispatched, which interventions HEMS teams perform in these patients, and whether HEMS interventions can be predicted by patient characteristics. Methods We performed retrospective cohort study of all patients with a reported unexplained LOC (e.g. not attributable to a circulatory arrest or seizures) attended by the Air Ambulance Kent, Surrey & Sussex (AAKSS), over a 4-year period (July 2013–December 2017). Primary outcome was defined as the number of HEMS-specific interventions performed in patients with unexplained LOC. Secondary outcome was the relation of clinical- and dispatch criteria with HEMS interventions being performed. Results During the study period, 127 patients with unexplained LOC were attended by HEMS. HEMS was dispatched directly to 25.2% of the patients, but mostly (74.8%) on request of the ground ambulance crews. HEMS interventions were performed in 65% of the patients (Prehospital Emergency Anaesthesia 56%, hyperosmolar therapy 21%, antibiotic/antiviral therapy 8%, vasopressor therapy 6%) and HEMS conveyed most patients (77%) to hospital. Acute neurological pathology was a prevalent underlying cause of unexplained LOC: 38% had gross pathology on their CT-scan upon arrival in hospital. Both GCS (r = − 0.60, p < .001) and SBP (r = 0.31, p < .001) were related to HEMS interventions being performed on scene. A GCS < 13 predicted the need for HEMS interventions in our population with a sensitivity of 94.9% and a specificity 75% (AUC 0.85). Conclusion HEMS dispatchers and ambulance personnel are able to identify a cohort of patients with unexplained LOC of medical origin who suffer from potentially life threatening (mainly neurological) pathology, in whom HEMS specific intervention are frequently required. Presenting GCS can be used to inform the triage process of patients with LOC at an early stage.

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Section: Hems Dispatchsupporting

confidence: 68%

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Mohindru¹,

Griggs²,

Coverly³

et al. 2020

BMC Emerg Med

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“…Willingness-and ability of callers to help may be lower in more urban areas, for example through the presence of language barriers. Since a bespoke tasking algorithm was used by our dispatchers [9], it was anticipated that the video footage from scene would be used in only a minority of the emergency calls made (21 during the study period). When dispatch criteria were already met during the emergency call, the HEMS team was dispatched instantly.…”

Section: Discussionmentioning

confidence: 99%

“…All dispatchers observe regularly on operational shifts to improve awareness, and participate in the AAKSS (ongoing) internal audit process. Dispatchers are aided by a bespoke tasking algorithm, devised by the AAKSS management team [9]. Whilst listening to the incoming emergency call, dispatchers aim to rapidly identify either one (from Grade 1 criteria list) or two (from Grade 2 criteria list) dispatch criteria [9].…”

Section: Hems Dispatch Protocolmentioning

confidence: 99%

“…Dispatchers are aided by a bespoke tasking algorithm, devised by the AAKSS management team [9]. Whilst listening to the incoming emergency call, dispatchers aim to rapidly identify either one (from Grade 1 criteria list) or two (from Grade 2 criteria list) dispatch criteria [9]. If these are positively identified, HEMS is dispatched.…”

Section: Hems Dispatch Protocolmentioning

confidence: 99%

See 1 more Smart Citation

Live video footage from scene to aid helicopter emergency medical service dispatch: a feasibility study

Avest¹,

Lambert²,

Coverly³

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background Obtaining accurate information from a 112 caller is key to correct tasking of Helicopter Emergency Medical Services (HEMS). Being able to view the incident scene via video from a mobile phone may assist HEMS dispatch by providing more accurate information such as mechanism of injury and/or injuries sustained. The objective of this study is to describe the acceptability and feasibility of using live video footage from the mobile phone of a 112 caller as an HEMS dispatch aid. Methods Live footage is obtained via the 112 caller’s mobile phone camera through the secure GoodSAM app’s Instant-on-scene™ platform. Video footage is streamed directly to the dispatcher, and not stored. During the feasibility trial period, dispatchers noted the purpose for which they used the footage and rated ease of use and any technical- and operational issues they encountered. A subjective assessment of caller acceptance to use video was conducted. Results Video footage from scene was attempted for 21 emergency calls. The leading reasons listed by the dispatchers to use live footage were to directly assess the patient (18/21) and to obtain information about the mechanism of injury and the scene (11/21). HEMS dispatchers rated the ease of use with a 4.95 on a 5-point scale (range 4–5). All callers gave permission to stream from their telephone camera. Video footage from scene was successfully obtained in 19 calls, and was used by the dispatcher as an aid to send (5) or stand down (14) a Helicopter Emergency Medical Services team. Conclusion Live video footage from a 112 caller can be used to provide dispatchers with more information from the scene of an incident and the clinical condition of the patient(s). The use of mobile phone video was readily accepted by the 112 caller and the technology robust. Further research is warranted to assess the impact video from scene could have on HEMS dispatching.

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“…In the literature, critical care interventions and the NACA score has been suggested as proxy markers for HEMS mission relevance [21]. In a recently published Scottish study, the authors found an overall 42% of HEMS missions appropriately tasked based on performed critical care interventions [22].…”

Section: Discussionmentioning

confidence: 99%

Characteristics of patients treated by the Danish Helicopter Emergency Medical Service from 2014-2018: a nationwide population-based study

Alstrup

Møller

Knudsen

et al. 2019

Scand J Trauma Resusc Emerg Med

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BackgroundA national Helicopter Emergency Medical Service (HEMS) was introduced in Denmark in 2014 to ensure the availability of physician-led critical care for all patients regardless of location.Appropriate dispatch of HEMS is known to be complex, and resource utilisation is a highly relevant topic. Population-based studies on patient characteristics are fundamental when evaluating and optimising a system. The aim of this study was to describe the patient population treated by the Danish HEMS in terms of demographics, pre-hospital diagnostics, severity of illness or injury, and the critical care interventions performed.MethodThe study is a retrospective nationwide population-based study based on data gathered from the Danish HEMS database. We included primary missions resulting in a patient encounter registered between October 1st 2014 and April 30th 2018.ResultsOf 13.391 dispatches registered in the study period we included 7133 (53%) primary missions with patient encounter: 4639 patients were air lifted to hospital, 174 patients were escorted to hospital by the HEMS physician in an ambulance, and in 2320 cases HEMS assisted the ground crew on scene but did not escort the patient to hospital. Patient age ranged from 0-99 years and 64% of the population were men. The median age was 60 years.The main diagnostic groups were cardio-vascular emergencies (41%), trauma (23%) and neurological emergencies (16%). In 61% of the cases, the patient was critically ill/injured corresponding to a NACA (National Advisory Committee for Aeronautics) score between 4 and 7 (both included). In more than one third of the missions a critical care intervention was performed. Ultrasound examination and endo-tracheal intubation were the critical care interventions most frequently performed (21% and 20%, respectively).ConclusionThe national Danish HEMS primarily attends severely ill or injured patients and often perform critical care interventions. In addition, the Danish HEMS provides rapid transport to highly specialised treatment for patients in the more rural parts of the country.Patients with cardio-vascular emergencies, trauma and neurological emergencies are among those patient groups most commonly seen.We conclude that the overall dispatch profile appears appropriate but emphasise that continuous development and refinement is essential.

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A novel method of non-clinical dispatch is associated with a higher rate of critical Helicopter Emergency Medical Service intervention

Cited by 25 publications

References 17 publications

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Live video footage from scene to aid helicopter emergency medical service dispatch: a feasibility study

Characteristics of patients treated by the Danish Helicopter Emergency Medical Service from 2014-2018: a nationwide population-based study

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