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A prospective evaluation of the availability and utility of the Ambulance Call Record in the emergency department

  • Natalie Cram (a1), Shelley McLeod (a2) (a3), Michael Lewell (a1) and Matthew Davis (a1)
  • Please note a correction has been issued for this article.

Abstract

Objective

To determine how often the Ambulance Call Record (ACR) was available to emergency department (ED) physicians and whether it contained information that changed the ED management of patients.

Methods

This was a prospective cohort study of adult patients transported to one of two tertiary care centre EDs. Physicians completed a data collection form for each patient regarding ACR availability and the perceived value of the ACR. This study began shortly after the implementation of a new electronic ACR (eACR) handover process (Round 1). To control for any confounding factors related to this new eACR handover process, the study was repeated 6 months after its implementation (Round 2).

Results

Total of 869 forms were collected: 545 in Round 1, and 324 in Round 2. The ACR was available at first physician assessment for 82 (15.7%) patients in Round 1, and 76 (24.4%) patients in Round 2 (Δ8.7%, 95% CI: 3.1%, 14.5%). The ACR was available at some point during patients’ ED stay for 154 (28.9%) patients in Round 1, compared to 111 (34.5%) patients in Round 2 (Δ5.6%, 95% CI: 0.0%, 12.1%). When the ACR was available for a patient (n=265), physicians believed that information in the ACR changed their treatment plan in 76 (28.8%) cases.

Conclusion

Physicians who review the ACR believe that the ACR contains relevant information that may influence patient management; however, physicians commonly manage patients without reviewing the ACR.

Objectifs

L’étude visait à déterminer dans quelle mesure les enregistreurs d’appels d’ambulance (EAA) étaient à la disposition des médecins et si les renseignements fournis influaient sur le traitement des patients au service des urgences (SU).

Méthode

Il s’agit d’une étude de cohorte prospective, composée d’adultes transportés à l’un des deux SU de soins tertiaires. Les médecins ont rempli, pour chacun des malades, un formulaire de collecte de données relativement à la présence ou non d’un EAA et à la perception de la valeur de ce type d’appareil. L’étude a commencé peu de temps après la mise en œuvre d’un processus de transfert de soins à l’aide d’un nouvel EAA électronique (1re étape). Six mois après la mise en œuvre du processus de transfert de soins (2e étape), l’étude a été reprise afin que soit éliminé tout facteur parasite lié à l’utilisation du nouvel EAA électronique.

Résultats

Au total, 869 formulaires ont été recueillis : 545 au cours de la 1re étape et 324 au cours de la 2e étape. Un EAA était disponible à la première évaluation médicale de 82 (15,7 %) patients au cours de la 1re étape et de 76 (24,4 %) patients au cours de la 2e étape (écart [Δ] 8,7 %; IC à 95 % : 3,1 %-14,5 %). Par ailleurs, les médecins avaient la possibilité d’écouter l’EAA à tout moment durant le séjour des patients au SU dans 154 (28,9 %) cas au cours de la 1re étape et dans 111 (34,5 %) cas au cours de la 2e étape (Δ 5,6 %; IC à 95 % : 0,0 %-12,1 %). Enfin, les médecins étaient d’avis que, lorsqu’il était possible d’écouter les EAA (n=265), les renseignements fournis avaient modifié le plan de traitement de 76 patients (28,8 %).

Conclusions

Les médecins qui écoutent les EAA estiment que les appareils fournissent des renseignements utiles, susceptibles de modifier le traitement des patients; toutefois, les médecins traitent généralement les patients sans écouter les EAA.

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Copyright

Corresponding author

Correspondence to: Dr. Natalie Cram, Southwest Ontario Regional Base Hospital Program, London Health Sciences Center, 4056 Meadowbrook Dr., Unit 145, London, ON N6L 1E5; Email: ncram2011@meds.uwo.ca

References

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1. Benner, J, Hilton, J, Carr, G, et al. Correspondence: information transfer from prehospital to ED health care providers. Am J Emerg Med 2008;26:233-244.
2. Scott, L, Brice, J, Baker, C, et al. An analysis of paramedic verbal reports to physicians in the emergency department trauma room. Prehosp Emerg Care 2003;7(2):247-251.
3. Talbot, R, Bleetman, A. Retention of information by emergency department staff at ambulance handover: do standardised approaches work? Emerg Med J 2007;24:539-542.
4. Stiell, A, Forster, AJ, Stiell, IG, et al. Prevalence of information gaps in the emergency department and the effect on patient outcomes. CMAJ 2003;169(10):1023-1028.
5. Evans, SM, Murray, A, Patrick, I, et al. Assessing clinical handover between paramedics and the trauma team. Injury 2010;41:460-464.
6. Carter, AJE, Davis, KA, Evans, LV, et al. Information loss in emergency medical services handover of trauma patients. Prehosp Emerg Care.
7. Yong, G, Dent, AW, Weiland, TJ. Handover from paramedics: observations and emergency department clinician perceptions. Emerg Med Australas 2008;20:149-155.
8. Jenkin, A, Abelsen-Mitchell, N, Cooper, S. Patient handover: time for a change? Accid Emerg Nurs 2007;15:141-147.
9. NAEMSP Position Statement. Transfer of patient care between EMS providers and receiving facilities. Prehosp Emerg Care 2014;18(2):305.
10. Ministry of Health and Long Term Care. Ambulance Service Documentation Standards; 2000. Available at: https://www.hsnsudbury.ca/portalen/Portals/23/Ontario%20Ambulance%20Documentation%20Standards.pdf?ver=2016-02-29-152040-183.
11. Yong, G, Dent, A, Weiland, T. Handover from paramedics: observations and emergency department clinician perceptions. Emerg Med Australas 2008;20(2):149-155.
12. Bledsoe, B, Wasden, C, Johnson, L. Electronic Prehospital Records are often unavailable for emergency department medical decision making. West J Emerg Med 2013;14(5):482-488.
13. Owen, C, Hemmings, L, Brown, T. Lost in translation: maximizing handover effectiveness between paramedics and receiving staff in the emergency department. Emerg Med Australas 2009;21:102-107.
14. Davis, M, Dukelow, A, McLeod, S, et al. The utility of the prehospital electrocardiogram. CJEM 2011;13(6):372-377.
15. Davis, M, Lewell, M, McLeod, S, et al. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change patient management in the emergency department. Prehosp Emerg Care 2015;18(1):9-14.
16. Waldron, R, Sixsmith, DM. Emergency physician awareness of prehospital procedures and medications. West J Emerg Med 2014;15(4):504-510.

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