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

  • Kenji Narikawa (a1), Tetsuya Sakamoto (a2), Katsuaki Kubota (a3), Masayuki Suzukawa (a4), Chikara Yonekawa (a4), Keisuke Yamashita (a4), Yoshiki Toyokuni (a5), Yasuharu Yasuda (a6), Akihiro Kobayashi (a7) and Kazunori Iijima (a7)...

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.

Copyright

Corresponding author

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

References

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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.
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.
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.
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.
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.
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.
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.
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.
9. Haga Area Fire Department. Annual Report 2011 [In Japanese].
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.
11.Agarwal, DA, Hess, EP, Atkinson, EJ, White, RD. Ventricular fibrillation in Rochester, Minnesota: experience over 18 years. Resuscitation. 2009 ; 80(11):1253-1258.
12.Scottish Ambulance Service. Scottish Ambulance Service First Responder – Strategy & Policy Document. Scotland: Scottish Ambulance Service; 2010.
13.London Ambulance Service Ambulance Operations Manager. First Responders Policy. London: London Ambulance Service; 2010.
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.
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.
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.
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.
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.

Keywords

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

  • Kenji Narikawa (a1), Tetsuya Sakamoto (a2), Katsuaki Kubota (a3), Masayuki Suzukawa (a4), Chikara Yonekawa (a4), Keisuke Yamashita (a4), Yoshiki Toyokuni (a5), Yasuharu Yasuda (a6), Akihiro Kobayashi (a7) and Kazunori Iijima (a7)...

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