Tags

Type your tag names separated by a space and hit enter

Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: an observational cohort study.
BMJ Open. 2022 May 16; 12(5):e058628.BO

Abstract

OBJECTIVE

To assess accuracy of emergency medical service (EMS) telephone triage in identifying patients who need an EMS response and identify factors which affect triage accuracy.

DESIGN

Observational cohort study.

SETTING

Emergency telephone triage provided by Yorkshire Ambulance Service (YAS) National Health Service (NHS) Trust.

PARTICIPANTS

12 653 adults who contacted EMS telephone triage services provided by YAS between 2 April 2020 and 29 June 2020 assessed by COVID-19 telephone triage pathways were included.

OUTCOME

Accuracy of call handler decision to dispatch an ambulance was assessed in terms of death or need for organ support at 30 days from first contact with the telephone triage service.

RESULTS

Callers contacting EMS dispatch services had an 11.1% (1405/12 653) risk of death or needing organ support. In total, 2000/12 653 (16%) of callers did not receive an emergency response and they had a 70/2000 (3.5%) risk of death or organ support. Ambulances were dispatched to 4230 callers (33.4%) who were not conveyed to hospital and did not deteriorate. Multivariable modelling found variables of older age (1 year increase, OR: 1.05, 95% CI: 1.04 to 1.05) and presence of pre-existing respiratory disease (OR: 1.35, 95% CI: 1.13 to 1.60) to be predictors of false positive triage.

CONCLUSION

Telephone triage can reduce ambulance responses but, with low specificity. A small but significant proportion of patients who do not receive an initial emergency response deteriorated. Research to improve accuracy of EMS telephone triage is needed and, due to limitations of routinely collected data, this is likely to require prospective data collection.

Authors+Show Affiliations

Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK. Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Yorkshire Ambulance Service NHS Trust, Wakefield, UK.Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK b.d.thomas@sheffield.ac.uk.Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Yorkshire Ambulance Service NHS Trust, Wakefield, UK.Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK.Centre for Health Information Management Research (CHIMR) and Health Informatics Research Group, Information School, University of Sheffield, Sheffield, UK.Clinical Trials Research Unit (CTRU), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.Centre for Urgent and Emergency Care Research (CURE), Health Services Research School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

35577471

Citation

Marincowitz, Carl, et al. "Accuracy of Emergency Medical Service Telephone Triage of Need for an Ambulance Response in Suspected COVID-19: an Observational Cohort Study." BMJ Open, vol. 12, no. 5, 2022, pp. e058628.
Marincowitz C, Stone T, Hasan M, et al. Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: an observational cohort study. BMJ Open. 2022;12(5):e058628.
Marincowitz, C., Stone, T., Hasan, M., Campbell, R., Bath, P. A., Turner, J., Pilbery, R., Thomas, B. D., Sutton, L., Bell, F., Biggs, K., Hopfgartner, F., Mazumdar, S., Petrie, J., & Goodacre, S. (2022). Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: an observational cohort study. BMJ Open, 12(5), e058628. https://doi.org/10.1136/bmjopen-2021-058628
Marincowitz C, et al. Accuracy of Emergency Medical Service Telephone Triage of Need for an Ambulance Response in Suspected COVID-19: an Observational Cohort Study. BMJ Open. 2022 May 16;12(5):e058628. PubMed PMID: 35577471.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: an observational cohort study. AU - Marincowitz,Carl, AU - Stone,Tony, AU - Hasan,Madina, AU - Campbell,Richard, AU - Bath,Peter A, AU - Turner,Janette, AU - Pilbery,Richard, AU - Thomas,Benjamin David, AU - Sutton,Laura, AU - Bell,Fiona, AU - Biggs,Katie, AU - Hopfgartner,Frank, AU - Mazumdar,Suvodeep, AU - Petrie,Jennifer, AU - Goodacre,Steve, Y1 - 2022/05/16/ PY - 2022/5/16/entrez PY - 2022/5/17/pubmed PY - 2022/5/20/medline KW - COVID-19 KW - accident & emergency medicine KW - risk management SP - e058628 EP - e058628 JF - BMJ open JO - BMJ Open VL - 12 IS - 5 N2 - OBJECTIVE: To assess accuracy of emergency medical service (EMS) telephone triage in identifying patients who need an EMS response and identify factors which affect triage accuracy. DESIGN: Observational cohort study. SETTING: Emergency telephone triage provided by Yorkshire Ambulance Service (YAS) National Health Service (NHS) Trust. PARTICIPANTS: 12 653 adults who contacted EMS telephone triage services provided by YAS between 2 April 2020 and 29 June 2020 assessed by COVID-19 telephone triage pathways were included. OUTCOME: Accuracy of call handler decision to dispatch an ambulance was assessed in terms of death or need for organ support at 30 days from first contact with the telephone triage service. RESULTS: Callers contacting EMS dispatch services had an 11.1% (1405/12 653) risk of death or needing organ support. In total, 2000/12 653 (16%) of callers did not receive an emergency response and they had a 70/2000 (3.5%) risk of death or organ support. Ambulances were dispatched to 4230 callers (33.4%) who were not conveyed to hospital and did not deteriorate. Multivariable modelling found variables of older age (1 year increase, OR: 1.05, 95% CI: 1.04 to 1.05) and presence of pre-existing respiratory disease (OR: 1.35, 95% CI: 1.13 to 1.60) to be predictors of false positive triage. CONCLUSION: Telephone triage can reduce ambulance responses but, with low specificity. A small but significant proportion of patients who do not receive an initial emergency response deteriorated. Research to improve accuracy of EMS telephone triage is needed and, due to limitations of routinely collected data, this is likely to require prospective data collection. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/35577471/Accuracy_of_emergency_medical_service_telephone_triage_of_need_for_an_ambulance_response_in_suspected_COVID_19:_an_observational_cohort_study_ DB - PRIME DP - Unbound Medicine ER -