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

Avest, Ewoud ter; Lambert, E. Warren; Coverly, Richard de; Tucker, Herbert F.; Griggs, J. E.; Wilson, Mark; Ghorbangholi, A; Williams, Julia; Lyon, Richard

doi:10.1186/s13049-019-0632-4

Cited by 34 publications

(53 citation statements)

References 12 publications

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“…Novel approaches which review call communication and conversation analysis between the caller or bystander and call taker may allow us to identify unknown criteria missing from reviews of dispatch accuracy. Similarly, live video-transmission from scene may help gauge physiological parameters and expedite dispatch [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Griggs

Barrett²,

Avest

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Helicopter Emergency Medical Services (HEMS) respond to serious trauma and medical emergencies. Geographical disparity and the regionalisation of trauma systems can complicate accurate HEMS dispatch. We sought to evaluate HEMS dispatch sensitivity in older trauma patients by analysing critical care interventions and conveyance in a well-established trauma system. Methods All trauma patients aged ≥65 years that were attended by the Air Ambulance Kent Surrey Sussex over a 6-year period from 1 July 2013 to 30 June 2019 were included. Patient characteristics, critical care interventions and hospital disposition were stratified by dispatch type (immediate, interrogate and crew request). Results 1321 trauma patients aged ≥65 were included. Median age was 75 years [IQR 69–89]. HEMS dispatch was by immediate (32.0%), interrogation (43.5%) and at the request of ambulance clinicians (24.5%). Older age was associated with a longer dispatch interval and was significantly longer in the crew request category (37 min [34–39]) compared to immediate dispatch (6 min [5–6] (p = .001). Dispatch by crew request was common in patients with falls < 2 m, whereas pedestrian road traffic collisions and falls > 2 m more often resulted in immediate dispatch (p = .001). Immediate dispatch to isolated head injured patients often resulted in pre-hospital emergency anaesthesia (PHEA) (39%). However, over a third of head injured patients attended after dispatch by crew request received PHEA (36%) and a large proportion were triaged to major trauma centres (69%). Conclusions Many patients who do not fulfil the criteria for immediate HEMS dispatch need advanced clinical interventions and subsequent tertiary level care at a major trauma centre. Further studies should evaluate if HEMS activation criteria, nuanced by age-dependant triggers for mechanism and physiological parameters, optimise dispatch sensitivity and HEMS utilisation.

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Section: Discussionmentioning

confidence: 99%

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Griggs

Barrett²,

Avest

et al. 2021

Scand J Trauma Resusc Emerg Med

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“…These efforts may increase bystander CPR rates and decrease time to first compression and defibrillation. Additionally, this may be complemented by videoassisted dispatching, as has been trialed by GoodSAM [28]. While this implementation focused on the remote initial assessment of trauma, studies have shown that video-assisted dispatching may improve the quality of DACPR provided compared to the current, audioinstructed method [29].…”

Section: Future Developmentsmentioning

confidence: 99%

Emergency medical dispatch services across Pan-Asian countries: a web-based survey

Lee

Mao

et al. 2020

BMC Emerg Med

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Background: Dispatch services (DS's) form an integral part of emergency medical service (EMS) systems. The role of a dispatcher has also evolved into a crucial link in patient care delivery, particularly in dispatcher assisted cardiopulmonary resuscitation (DACPR) during out-of-hospital cardiac arrest (OHCA). Yet, there has been a paucity of research into the emerging area of dispatch science in Asia. This paper compares the characteristics of DS's, and state of implementation of DACPR within the Pan-Asian Resuscitation Outcomes (PAROS) network. Methods: A cross-sectional descriptive survey addressing population characteristics, DS structures and levels of service, state of DACPR implementation (including protocols and quality improvement programs) among PAROS DS's. Results: 9 DS's responded, representing a total of 23 dispatch centres from 9 countries that serve over 80 million people. Most PAROS DS's operate a tiered dispatch response, have implemented medical oversight, and tend to be staffed by dispatchers with a predominantly medical background. Almost all PAROS DS's have begun tracking key EMS indicators. 77.8% (n = 7) of PAROS DS's have introduced DACPR. Of the DS's that have rolled out DACPR, 71.4% (n = 5) provided instructions in over one language. All DS's that implemented DACPR and provided feedback to dispatchers offered feedback on missed OHCA recognition. The majority of DS's (83.3%; n = 5) that offered DACPR and provided feedback to dispatchers also implemented corrective feedback, while 66.7% (n = 4) offered positive feedback. Compression-only CPR was the standard instruction for PAROS DS's. OHCA recognition sensitivity varied widely in PAROS DS's, ranging from 32.6% (95% CI: 29.9-35.5%) to 79.2% (95% CI: 72.9-84.4%). Median time to first compression ranged from 120 s to 220 s. Conclusions: We found notable variations in characteristics and state of DACPR implementation between PAROS DS's. These findings will lay the groundwork for future DS and DACPR studies in the PAROS network.

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“…However, no combination of clinical criteria alone is perfect. Novel approaches focussing on communication in the initial call [ 20 ] and live video transmission from scene [ 21 ] may help to identify patients needing HEMS interventions earlier.…”

Section: Discussionmentioning

confidence: 99%

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

Cited by 34 publications

References 12 publications

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?

Emergency medical dispatch services across Pan-Asian countries: a web-based survey

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

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