1
|
Idland S, Kramer-Johansen J, Bakke HK, Hagen M, Tønsager K, Platou HCS, Hjortdahl M. Can video streaming improve first aid for injured patients? A prospective observational study from Norway. BMC Emerg Med 2024; 24:89. [PMID: 38807042 PMCID: PMC11131190 DOI: 10.1186/s12873-024-01010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Video streaming in emergency medical communication centers (EMCC) from caller to medical dispatcher has recently been introduced in some countries. Death by trauma is a leading cause of death and injuries are a frequent reason to contact EMCC. We aimed to investigate if video streaming is associated with recognition of a need for first aid during calls regarding injured patients and improve quality of bystander first aid. METHODS A prospective observational study including patients from three health regions in Norway, from November 2021 to February 2023 (registered in clinical trials 10/25/2021, NCT05121649). Cases where video streaming had been used as a supplement during the medical emergency call were compared to cases where video streaming was not used during the call. Patients were included by ambulance personnel on the scene of accident if they met the following criteria: 1. Ambulance personnel arrived at a patient who had an injury, 2. One or more bystanders had been present before their arrival, 3. One or more of the following first aid measures had been performed by bystander or should have been performed: airway management, control of external bleeding, recovery position, and hypothermia prevention. Ambulance personnel assessed quality of first aid performed by bystander, and information concerning use of video streaming and patient need for first aid measures recognized by dispatcher was collected through EMCC audio logs and patient charts. We present descriptive data and results from a logistic regression analysis. RESULTS Data was collected on 113 cases, and dispatchers used video streaming in addition to standard telephone communication in 12/113 (10%) of the cases. The odds for the dispatcher to recognize a need for first aid during a medical emergency call were more than five times higher when video streaming was used compared to no use of video streaming (OR 5.30, 95% CI 1.11-25.44). Overall quality of bystander first aid was rated as "high". The odds ratio for the patient receiving first aid of higher quality were 1.82 (p-value 0.46) when video streaming was used by dispatcher during the call. CONCLUSION Our findings show that video streaming is not frequently used by dispatchers in calls regarding patients with injuries, but that video streaming is associated with improved recognition of patients' first aid needs. We found no statistically significant difference in first aid quality comparing the calls where video streaming as a supplement were used with the calls with audio only.
Collapse
Affiliation(s)
- Siri Idland
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway.
- Division of Prehospital Services, Oslo University Hospital, Oslo, Norway.
| | - Jo Kramer-Johansen
- Division of Prehospital Services, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Håkon Kvåle Bakke
- Department of Anaesthesia and Critical Care, University Hospital of North Norway, Tromsø, Norway
- Department of Health and Care Sciences, Faculty of Health Science, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Milada Hagen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Tønsager
- Air Ambulance Department, Stavanger University Hospital, Pre-hospital Division, Stavanger, Norway
- The Norwegian Air Ambulance Foundation, Oslo, Norway
- Department of Health Studies, University of Stavanger, Stavanger, Norway
| | | | - Magnus Hjortdahl
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Division of Prehospital Services, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
2
|
Harring AKV, Blinkenberg J, Brattebø G, Hjortdahl M, Idland S, Iversen E, Leonardsen ACL, Zakariassen E, Jørgensen TM. The MeSH heading "Call Center" is due for an update: why we recommend the more precise heading "Emergency Medical Communication Center". Scand J Trauma Resusc Emerg Med 2023; 31:91. [PMID: 38049913 PMCID: PMC10696673 DOI: 10.1186/s13049-023-01155-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 12/06/2023] Open
Abstract
Call centers can be found in various industries. However as a Medical Subject Heading (MeSH) the term "Call centers" does not reflect the critical purpose of handling emergency calls. We recommend "emergency medical communication center(s)", as this provides clarity and precision regarding the primary function and purpose of the center.
Collapse
Affiliation(s)
- Astrid K V Harring
- Oslo Metropolitan University, PB 4, St. Olavs plass, Oslo, 0130, Norway.
| | - Jesper Blinkenberg
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Guttorm Brattebø
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Norwegian National Advisory Unit on Emergency Medical Communication (KoKom), Haukeland University Hospital, Bergen, Norway
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
| | - Magnus Hjortdahl
- Oslo Metropolitan University, PB 4, St. Olavs plass, Oslo, 0130, Norway
- Division of Prehospital Services, Oslo University Hospital, Oslo, Norway
| | - Siri Idland
- Oslo Metropolitan University, PB 4, St. Olavs plass, Oslo, 0130, Norway
| | - Emil Iversen
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
- Norwegian National Advisory Unit on Emergency Medical Communication (KoKom), Haukeland University Hospital, Bergen, Norway
| | | | - Erik Zakariassen
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre AS, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Trine M Jørgensen
- Oslo Metropolitan University, PB 4, St. Olavs plass, Oslo, 0130, Norway
| |
Collapse
|
3
|
Kirby K, Voss S, Benger J. Identifying patients at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical call: The views of call-takers. Resusc Plus 2023; 16:100490. [PMID: 38026142 PMCID: PMC10630112 DOI: 10.1016/j.resplu.2023.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/19/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction There is little research on the triage of patients who are not yet in cardiac arrest when the emergency call is initiated, but who deteriorate and suffer a cardiac arrest during the prehospital phase of care. The aim of this study was to investigate Emergency Operation Centre staff views on ways to improve the early identification of patients who are at imminent risk of cardiac arrest, and the barriers to achieving this. Methods A qualitative interview and focus group study was conducted in two large Emergency Medical Services in England, United Kingdom. Twelve semi-structured interviews and one focus group were completed with Emergency Operations Centre staff. Data were analysed using reflexive thematic analysis. Results Three main themes were identified: The dispatch protocol and call-taker audit; Identifying and responding to deteriorating patients; Education, knowledge and skills. Barriers to recognising patients at imminent risk of cardiac arrest include a restrictive dispatch protocol, limited opportunity to monitor a patient, compliance auditing and inadequate education. Clinician support is not always optimal, and a lack of patient outcome feedback restricts dispatcher learning and development. Suggested remedies include improvements in training and education (call-takers and the public), software, clinical support and patient outcome feedback. Conclusions Emergency Operation Centre staff identified a multitude of ways to improve the identification of patients who are at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical Service call. Suggested areas for improvement include education, triage software, clinical support redesign and patient outcome feedback.
Collapse
Affiliation(s)
- Kim Kirby
- University of the West of England, Bristol, United Kingdom
- South Western Ambulance Service NHS Foundation Trust, United Kingdom
| | - Sarah Voss
- University of the West of England, Bristol, United Kingdom
| | | |
Collapse
|
4
|
Karlsson S, Gyllencreutz L. Situation awareness of emergency response centre personnel during chemical incidents: an interview study in a Swedish context. BMJ Open 2023; 13:e071347. [PMID: 37316314 DOI: 10.1136/bmjopen-2022-071347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES If a chemical incident occurs, the emergency response centre (ERC) personnel are the first that are notified. They need to quickly attain situation awareness, based on the information from the caller, in order to dispatch the correct emergency units. The aim of this study is to examine the situation awareness of the personnel working at ERCs-how they perceive, comprehend, project and act during chemical incidents. METHODS Semi-structured individual interviews with 12 participants from the Swedish ERCs were performed. The interviews were analysed with qualitative content analysis. RESULTS Three categories of responses were identified. Responses focused on the complexity of identifying chemical incidents, the importance of ensuring the safety of citizens and personnel of emergency organisations and the situation-based dispatch of organisations. CONCLUSIONS The correct identification of the chemical incident and the involved chemical by the ERC personnel are necessary in order to notify, inform and dispatch the correct units, as well as to ensure the safety of citizens and emergency personnel. More research is needed about the dichotomies of the ERC personnel needing as much information as possible for everyone's safety versus their responsibility for the safety of the caller as well as between using emergency dispatch index interview guides and trusting their gut feeling.
Collapse
Affiliation(s)
- Sofia Karlsson
- Umeå University, Department of Surgical and Perioperative Sciences, Surgery, Umeå, Sweden
| | - Lina Gyllencreutz
- Umeå University, Department of Surgical and Perioperative Sciences, Surgery, Umeå, Sweden
- Umeå University, Department of Nursing, Umeå, Sweden
| |
Collapse
|
5
|
Torlén Wennlund K, Kurland L, Olanders K, Khoshegir A, Kamil HA, Castrén M, Bohm K. Emergency medical dispatchers' experiences of managing emergency calls: a qualitative interview study. BMJ Open 2022; 12:e059803. [PMID: 35418440 PMCID: PMC9014079 DOI: 10.1136/bmjopen-2021-059803] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To explore the emergency medical dispatchers (EMDs) experiences of managing emergency medical calls. DESIGN A qualitative interview study with an inductive approach. EMDs were interviewed individually using a semistructured interview guide. The verbatim transcripts were analysed using a qualitative content analysis. SETTING EMDs, without a professional background as registered nurses, were recruited from emergency medical communication centers (EMCCs) within Sweden. PARTICIPANTS To achieve a varied description of EMDs' experiences, participants were included from several EMCCs nationally, using a convenience sampling. Interviews were performed up until saturation of data, resulting in 13 EMDs from 7 EMCCs being interviewed. All the EMDs were women, ranging in age from 28 to 61 years (mean 42 years), and had worked in emergency medical dispatching between 1 and 13.5 years (mean 6.5 years). RESULTS The analysis revealed the main category-to attentively manage a multifaceted, interactive task-made up of three categories: utilize creativity to gather information, continuously process and assess complex information, and engage in the professional role. The content of each category was reflected in several subcategories further described and illustrated with representative quotes. CONCLUSIONS Managing emergency medical calls was experienced by EMDs to attentively manage a multifaceted interactive task. Core parts were described as: the ability to utilize creativity to gather information, continuously process and asses complex information, and engage in the professional role. Our results could be beneficial for emergency care managers when designing training programmes and organising EMD work and the EMD work environment, including further development of dispatch protocols and implementation of regular feedback sessions. Moreover, the results indicate that aspects such as self-awareness and emotional challenges encountered during EMD work could be important matters to discuss during staff evaluations.
Collapse
Affiliation(s)
- Klara Torlén Wennlund
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
| | - Lisa Kurland
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
- Department of Medical Sciences, Örebro University, Örebro, Sweden
| | - Knut Olanders
- Department of Intensive and Perioperative Care, Skåne University Hospital Lund, Lund, Sweden
| | - Amanda Khoshegir
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Hussein Al Kamil
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | - Maaret Castrén
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
- Department of Emergency Medicine, University of Helsinki, Helsinki, Finland
| | - Katarina Bohm
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden
- Emergency Department, Södersjukhuset, Stockholm, Sweden
| |
Collapse
|
6
|
Gerwing J, Steen-Hansen JE, Mjaaland T, Jensen BF, Eielsen O, Thomas OMT, Gulbrandsen P. Evaluating a training intervention for improving alignment between emergency medical telephone operators and callers: a pilot study of communication behaviours. Scand J Trauma Resusc Emerg Med 2021; 29:107. [PMID: 34332640 PMCID: PMC8325801 DOI: 10.1186/s13049-021-00917-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background Calls to emergency medical lines are an essential component in the chain of survival. Operators make critical decisions based on information they elicit from callers. Although smooth cooperation is necessary, the field lacks evidence-based guidelines for how to achieve it while adhering to strict parameters of index-driven questioning. We aimed to evaluate the effect of a training intervention for emergency medical operators at a call centre in Tønsberg, Norway. The course was designed to enhance operators’ communication skills for smoothing cooperation with callers. Methods Calls were analyzed using inductively developed coding based on the course rationale and content. To evaluate whether the course generated consolidated behavioral change in everyday practice, the independent analyst evaluated 32 calls, selected randomly from eight operators, two calls before and two after course completion. To measure whether skill attainment delayed decision making, we compared the time to the first decision logged by intervention operators to eight control operators. Analysis included 3034 calls: 1375 to intervention operators (T1 = 815; T2 = 560) and 1659 to control operators (T1 = 683; T2 = 976). Results Operators demonstrated improved behaviours on how they greeted the caller (p < .001), acknowledged the caller (p < .001), and displayed empathy (p = 0.015). No change was found in the use of open-ended questions and agreeing with the caller. Contrary to expectations, operators who took the course logged first decisions more quickly than the control group (p < .001). Conclusions This pilot study demonstrated that the training intervention generated behavioural change in these operators, providing justification for scaling up the intervention. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00917-y.
Collapse
Affiliation(s)
- Jennifer Gerwing
- Health Services Research Unit, Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway.
| | - Jon Erik Steen-Hansen
- Division of Prehospital Care, Vestfold Hospital Trust, Box 2168, NO-3103, Tønsberg, Norway
| | - Trond Mjaaland
- Somsagt AS, Forskningsparken / Oslo Science Park, Gaustadalleen 21, 0349, Oslo, Norway
| | - Bård Fossli Jensen
- Somsagt AS, Forskningsparken / Oslo Science Park, Gaustadalleen 21, 0349, Oslo, Norway
| | | | | | - Pål Gulbrandsen
- Health Services Research Unit, Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, PO box 1171, Blindern, 0318, Oslo, Norway
| |
Collapse
|
7
|
Kaminsky E, Lindberg Y, Spangler D, Winblad U, K Holmström I. Registered nurses' understandings of emergency medical dispatch center work: A qualitative phenomenographic interview study. Nurs Health Sci 2021; 23:430-438. [PMID: 33665977 DOI: 10.1111/nhs.12824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
Non-urgent and urgent telephone nursing services are increasing globally, and phenomenographic research has shown that how work is understood may influence work performance. This descriptive study makes a qualitative inductive investigation of understandings of emergency medical dispatch center work among registered nurses. Twenty-four registered nurses at three mid Swedish emergency medical dispatch centers were interviewed. Analysis based on phenomenographic principles identified five categories in the interviews: (i) Assess, prioritize, direct, or refer; (ii) Facilitate ambulance nursing work; (iii) Perform nursing care; (iv) Always be available for the public; and (v) Have the person behind the patient in mind. The first constitutes the basis of the work. The second emphasizes cooperation with and support for the ambulance staff. The third entails remotely providing nursing care, whilst the fourth stresses serving the entire population. The fifth and most comprehensive way of understanding work involves having a holistic view of the person in need, including person-centered care. Provision of high-quality emergency medical dispatch center work involves all categories. Combined, they constitute a "work map," valuable for reflection, competence development, and introduction of new staff.
Collapse
Affiliation(s)
- Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Lindberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Douglas Spangler
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Uppsala Center for Prehospital Research, Department of Surgical Sciences - Anesthesia and Intensive Care, Uppsala University, Uppsala, Sweden
| | - Ulrika Winblad
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Inger K Holmström
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| |
Collapse
|