Implementierungsgrad der strukturierten Notrufabfrage in deutschen Leitstellen und Auswirkungen ihrer Einführung

Luiz, T.; Marung, H.; Pollach, Gregor; Hackstein, A.

doi:10.1007/s00101-019-0570-6

Cited by 20 publications

(13 citation statements)

References 23 publications

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“…However, regarding the negative predictive values, the absence of differences between the two groups indicates that the implementation of protocols for severe situations did not significantly worsen the under-triage. Conversely, the implementation of specific protocols in our SBD system appeared to improve the accuracy of emergency medical dispatching; this confirms the results of a survey on German EMCCs, concerning the impact of taking structured emergency calls [34].…”

Section: Discussionsupporting

confidence: 82%

Symptom-Based Dispatching in an Emergency Medical Communication Centre: Sensitivity, Specificity, and the Area under the ROC Curve

Larribau

Chappuis

Cottet

et al. 2020

IJERPH

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Background: Measuring the performance of emergency medical dispatch tools used in paramedic-staffed emergency medical communication centres (EMCCs) is rarely performed. The objectives of our study were, therefore, to measure the performance and accuracy of Geneva’s dispatch system based on symptom assessment, in particular, the performance of ambulance dispatching with lights and sirens (L&S) and to measure the effect of adding specific protocols for each symptom. Methods: We performed a prospective observational study including all emergency calls received at Geneva’s EMCC (Switzerland) from 1 January 2014 to 1 July 2019. The risk levels selected during the emergency calls were compared to a reference standard, based on the National Advisory Committee for Aeronautics (NACA) scale, dichotomized to severe patient condition (NACA ≥ 4) or stable patient condition (NACA < 4) in the field. The symptom-based dispatch performance was assessed using a receiver operating characteristic (ROC) curve. Contingency tables and a Fagan nomogram were used to measure the performance of the dispatch with or without L&S. Measurements were carried out by symptom, and a group of symptoms with specific protocols was compared to a group without specific protocols. Results: We found an acceptable area under the ROC curve of 0.7474, 95%CI (0.7448–0.7503) for the 148,979 assessments included in the study. Where the severity prevalence was 21%, 95%CI (20.8–21.2). The sensitivity of the L&S dispatch was 87.5%, 95%CI (87.1–87.8); and the specificity was 47.3%, 95%CI (47.0–47.6). When symptom-specific assessment protocols were used, the accuracy of the assessments was slightly improved. Conclusions: Performance measurement of Geneva’s symptom-based dispatch system using standard diagnostic test performance measurement tools was possible. The performance was found to be comparable to other emergency medical dispatch systems using the same reference standard. However, the implementation of specific assessment protocols for each symptom may improve the accuracy of symptom-based dispatch systems.

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Section: Discussionsupporting

confidence: 82%

Symptom-Based Dispatching in an Emergency Medical Communication Centre: Sensitivity, Specificity, and the Area under the ROC Curve

Larribau

Chappuis

Cottet

et al. 2020

IJERPH

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“…Einer Befragung aus dem Jahr 2017 zufolge, an der sich 100 der geschätzt ca. 220 Leitstellen beteiligten, lag der Implementierungsgrad noch unter 50% (Luiz et al 2019). Aufgrund der subjektiven Einschätzung verbesserte sich die Abfrage-und Dispositionsqualität bei mehr als 90% der teilnehmenden Leitstellen.…”

Section: Erfahrungen Mit Strukturierten Abfragesystemenunclassified

“…In der o.g. Studie(Luiz et al 2019) blieb der Anteil der Notarzteinsätze an den Notfalleinsätzen in 46% der Fälle weitgehend unverändert, verringerte sich bei 43% leicht und stieg bei 11% leicht an. Auch die Notarztnachalarmierungsquote blieb in 48% der Fälle unverändert, verminderte sich bei weiteren 48% und erhöhte sich nur bei 4%.…”

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Digitalisierung im Rettungsdienst

Luiz¹

2020

Qualitätsmonitor 2020

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“…Following oxygenation and intubation, the child was discharged from the clinic a short time later with no evidence of neurological deficits. [2,3]. Hierbei gilt, dass der Leitstellendisponent immer dann von einem Herz-Kreislauf-Stillstand ausgehen muss, wenn Patienten nicht reagieren und nicht normal atmen [4].…”

Section: Introductionunclassified

Akzidentelle Hydromorphon-Ingestion eines Kleinkindes und lebensrettende Telefonreanimation durch die Leitstelle

2020

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ZusammenfassungNotarzteinsatzfahrzeug und Rettungswagen wurden zu einem 14 Monate alten Kind mit Bewusstlosigkeit und ineffektiver Atmung alarmiert. Durch die Leitstelle erfolgte die Anleitung zu einer Telefonreanimation. Klinisch imponierten eine Miosis, eine massive Ateminsuffizienz sowie eine tiefe Bewusstlosigkeit. Erst im Verlauf konnte fremdanamnestisch in der Klinik festgestellt werden, dass dem Vater des Kindes zuvor mehrere Tabletten Hydromorphon auf den Boden gefallen sind. Nach Oxygenierung und Intubation konnte das Kind nach kurzer Zeit ohne neurologisches Defizit aus der Klinik entlassen werden.

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Implementierungsgrad der strukturierten Notrufabfrage in deutschen Leitstellen und Auswirkungen ihrer Einführung

Cited by 20 publications

References 23 publications

Symptom-Based Dispatching in an Emergency Medical Communication Centre: Sensitivity, Specificity, and the Area under the ROC Curve

Symptom-Based Dispatching in an Emergency Medical Communication Centre: Sensitivity, Specificity, and the Area under the ROC Curve

Digitalisierung im Rettungsdienst

Akzidentelle Hydromorphon-Ingestion eines Kleinkindes und lebensrettende Telefonreanimation durch die Leitstelle

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