Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-27T08:05:21.841Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders

Published online by Cambridge University Press:  16 September 2014

Kenji Narikawa ,
Tetsuya Sakamoto ,
Katsuaki Kubota ,
Masayuki Suzukawa ,
Chikara Yonekawa ,
Keisuke Yamashita ,
Yoshiki Toyokuni ,
Yasuharu Yasuda ,
Akihiro Kobayashi  and
Kazunori Iijima
Kenji Narikawa*
Affiliation:
Department of Sport and Medical Science Paramedic Course, Faculty of Medical Technology, Teikyo University, Itabashi, Tokyo, Japan
Tetsuya Sakamoto
Affiliation:
School of Medicine, Department of Emergency Medicine, Trauma and Resuscitation Center, Teikyo University, Itabashi, Tokyo, Japan
Katsuaki Kubota
Affiliation:
National Research Institute of Fire and Disaster of Japan, Tyofu, Tokyo, Japan
Masayuki Suzukawa
Affiliation:
Department of Emergency and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
Chikara Yonekawa
Affiliation:
Department of Emergency and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
Keisuke Yamashita
Affiliation:
Department of Emergency and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
Yoshiki Toyokuni
Affiliation:
Post-graduate School, Jichi Medical University, Shimotsuke, Tochigi, Japan
Yasuharu Yasuda
Affiliation:
Hiroshima International University, Department of Clinical Engineering, Higashi-Hiroshima, Hiroshima, Japan
Akihiro Kobayashi
Affiliation:
Administration Division, Haga Fire Department, Mooka, Tochigi, Japan
Kazunori Iijima
Affiliation:
Administration Division, Haga Fire Department, Mooka, Tochigi, Japan
*
Correspondence: Kenji Narikawa, BS, EMT-P Department of Sport and Medical Science Paramedic Course Faculty of Medical Technology Teikyo University 2-11-1 Kaga Itabashi-ku Tokyo, Japan 173-8605 E-mail narikawa@med.teikyo-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Shortening response time to an emergency call leads to the success of resuscitation by chest compression and defibrillation. However, response by ambulance or fire truck is not fast enough for resuscitation in Japan. In rural areas, response times can be more than 10 minutes. One possible way to shorten the response time is to establish a system of first responders (eg, police officers or firefighters) who are trained appropriately to perform resuscitation. Another possible way is to use a system of Community First Responders (CFRs) who are trained neighbors. At present, there are no call triage protocols to decide if dispatchers should activate CFRs.

Objective

The aim of this study was to determine the predictability to detect if dispatchers should activate CFRs.

Methods

Two CFR call triage protocols (CFR protocol Ver.0 and Ver.1) were established. The predictability of CFR protocols was examined by comparing the paramedic field reports. From the results of sensitivity of CFR protocol, the numbers of annual CFR activations were calculated. All data were collected, prospectively, for four months from October 1, 2012 through January 31, 2013.

Results

The ROC-AUC values appear slightly higher in CFR protocol Ver.1 (0.857; 95% CI, 79.8-91.7) than in CFR protocol Ver.0 (0.847; 95% CI, 79.0-90.3). The number of annual CFR activations is higher in CFR protocol Ver.0 (7.47) than in CFR protocol Ver.1 (5.45).

Conclusion

Two call triage protocols have almost the same predictability as the Medical Priority Dispatch System (MPDS). The study indicates that CFR protocol Ver.1 is better than CFR protocol Ver.0 because of the higher predictability and low number of activations. Also, it indicates that CFRs who are not medical professionals can respond to a patient with cardiac arrest.

NarikawaK, SakamotoT, KubotaK, SuzukawaM, YonekawaC, YamashitaK, ToyokuniY, YasudaY, KobayashiA, IijimaK. Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders. Prehosp Disaster Med. 2014;29(5):1-5.

Keywords

cardiac arrestemergency responderstriage
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 5 , October 2014 , pp. 484 - 488
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Travers, AH, Rea, TD, Bobrow, BJ, et al. Part 4: CPR Overview: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122:S676-S684.Google Scholar
2.Wissenberg, M, Lippert, FK, Folke, F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013;310(13):1377-1384.CrossRefGoogle ScholarPubMed
3.Ambulance Service Planning Office of Fire and Disaster Management Agency of Japan. Ministry of Affairs and Communications. Change of ambulance arrival time to the scene (national average) [in Japanese]. P.63. http://www.fdma.go.jp/neuter/topics/houdou/h21/2101/210122-2houdou_h.pdf. Accessed May 1, 2013.Google Scholar
4.Ambulance Service Planning Office of Fire and Disaster Management Agency of Japan. Ministry of Affairs and Communications. Change of ambulance arrival time to the scene (national average) [In Japanese]. P. 103. http://www.fdma.go.jp/neuter/topics/kyukyukyujo_genkyo/h24/01_kyukyu.pdf. Accessed May 1, 2013.Google Scholar
5.Ambulance Service Planning Office of Fire and Disaster Management Agency of Japan. Ministry of Affairs and Communications. Change of ambulance arrival time to the scene (national average) [In Japanese]. P 59-60. http://www.fdma.go.jp/neuter/topics/kyukyukyujo_genkyo/h24/01_kyukyu.pdf. Accessed May 1, 2013.Google Scholar
6.White, RD, Asplin, BR, Bugliosi, TF, Hankins, DG. High discharge survival rate after out-of-hospital ventricular fibrillation with rapid defibrillation by police and paramedics. Ann Emerg Med. 1996 Nov;28(5):480-485.CrossRefGoogle ScholarPubMed
7.Bach, A, Christensen, EF. Accuracy in identifying patients with loss of consciousness in a police-operated emergency call centre—first step in the chain of survival. Acta Anaesthesiol Scand. 2007;51(6):742-746.Google Scholar
8.Smith, KL, Peeters, A, McNeil, JJ. Results from the first 12 months of a fire first-responder program in Australia. Resuscitation. 2001;49(2):143-150.Google Scholar
9. Haga Area Fire Department. Annual Report 2011 [In Japanese].Google Scholar
10.Fire and Disaster Management Agency of Japan. Ministry of Affairs and Communications. Study Group Reports of triage system in ambulance service [in Japanese]. March 2007.Google Scholar
11.Agarwal, DA, Hess, EP, Atkinson, EJ, White, RD. Ventricular fibrillation in Rochester, Minnesota: experience over 18 years. Resuscitation. 2009 ; 80(11):1253-1258.Google Scholar
12.Scottish Ambulance Service. Scottish Ambulance Service First Responder – Strategy & Policy Document. Scotland: Scottish Ambulance Service; 2010.Google Scholar
13.London Ambulance Service Ambulance Operations Manager. First Responders Policy. London: London Ambulance Service; 2010.Google Scholar
14.Queensland Ambulance Service. First responder honorary ambulance office: help close at hand. https://ambulance.qld.gov.au/docs/First_Responder-as_at_Dec2013.pdf. Accessed May 12, 2013.Google Scholar
15.Clawson, J, Barron, T, Scott, G, Siriwardena, AN, Patterson, B, Olola, C. Medical Priority Dispatch System breathing problems protocol key question combinations are associated with patient acuity. Prehosp Disaster Med. 2012;27(4):375-380.CrossRefGoogle ScholarPubMed
16.Flynn, J, Archer, F, Morgans, A. Sensitivity and specificity of the medical priority dispatch system in detecting cardiac arrest emergency calls in Melbourne. Prehosp Disaster Med. 2006;21(2):72-76.Google Scholar
17.Key, CB, Pepe, PE, Persse, DE, Calderon, D. Can first responders be sent to selected 9-1-1emergency medical services calls without an ambulance? Acad Emerg Med. 2003;10(4):339-346.Google Scholar
18.Van Alem, AP, Vrenken, RH, de Vos, R, Tijssen, JG, Koster, RW. Use of automated external defibrillator by first responders in out of hospital cardiac arrest: prospective controlled trial. BMJ. 2003;327(7427):1312.Google Scholar