Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Original Research

Andrew Downes¹  Edward B. G. Barnard²  Christopher T. Edmunds³  Rob Major³  Kate Lachowycz³  Sarah McLachlan⁴  Andrew Smith⁵ 

[1] Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Gambling Close, Norwich Airport, NR6 6EG, Norwich, UK;Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Gambling Close, Norwich Airport, NR6 6EG, Norwich, UK;Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Clinical Innovation), Birmingham, UK;Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK;Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Gambling Close, Norwich Airport, NR6 6EG, Norwich, UK;University of East Anglia, Norwich, UK;Essex & Herts Air Ambulance Trust, Colchester, Essex, UK;Anglia Ruskin University, Cambridge, UK;Magpas Air Ambulance, Huntingdon, UK;

关键词: Air ambulances;    Emergency medical dispatch;    Emergency medical services;    Prehospital emergency care;   

DOI  :  10.1186/s13049-023-01094-w

 received in 2023-02-24, accepted in 2023-06-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHelicopter Emergency Medical Services (HEMS) are a limited and expensive resource, and should be intelligently tasked. HEMS dispatch was identified as a key research priority in 2011, with a call to identify a ‘general set of criteria with the highest discriminating potential’. However, there have been no published data analyses in the past decade that specifically address this priority, and this priority has been reaffirmed in 2023. The objective of this study was to define the dispatch criteria available at the time of the initial emergency call with the greatest HEMS utility using a large, regional, multi-organizational dataset in the UK.MethodsThis retrospective observational study utilized dispatch data from a regional emergency medical service (EMS) and three HEMS organisations in the East of England, 2016–2019. In a logistic regression model, Advanced Medical Priority Dispatch System (AMPDS) codes with ≥ 50 HEMS dispatches in the study period were compared with the remainder to identify codes with high-levels of HEMS patient contact and HEMS-level intervention/drug/diagnostic (HLIDD). The primary outcome was to identify AMPDS codes with a > 10% HEMS dispatch rate of all EMS taskings that would result in 10–20 high-utility HEMS dispatches per 24-h period in the East of England. Data were analysed in R, and are reported as number (percentage); significance was p < 0.05.ResultsThere were n = 25,491 HEMS dispatches (6400 per year), of which n = 23,030 (90.3%) had an associated AMPDS code. n = 13,778 (59.8%) of HEMS dispatches resulted in patient contact, and n = 8437 (36.6%) had an HLIDD. 43 AMPDS codes had significantly greater rates of patient contact and/or HLIDD compared to the reference group. In an exploratory analysis, a cut-off of ≥ 70% patient contact rate and/or ≥ 70% HLIDD (with a > 10% HEMS dispatch of all EMS taskings) resulted in 17 taskings per 24-h period. This definition derived nine AMPDS codes with high HEMS utility.ConclusionWe have identified nine ‘golden’ AMPDS codes, available at the time of initial emergency call, that are associated with high-levels of whole-system and HEMS utility in the East of England. We propose that UK EMS should consider immediate HEMS dispatch to these codes.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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