Ek Bosse, Edström Pontus, Toutin Anders, Svedlund Marianne
Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
Int Emerg Nurs. 2013 Apr;21(2):143-9. doi: 10.1016/j.ienj.2011.11.006. Epub 2011 Dec 29.
The need of emergency help often begins with a call to a dispatch center. The operator uses a medical index to prioritize dispatches. Since the resources of ambulances are limited, it is important that the priority grading decided by the operator at the dispatch center is as adequate as possible. In the county of Jamtland in Sweden, a system for triage named METTS-A (Medical Emergency Triage and Treatment System-A) has been in use since 2009, when the patient is coded according to priority level. The aim of this study was to analyse the sensitivity and specificity of the priority grading made by the dispatch center in comparison with the METTS-A priority assessed by the ambulance nurse. Statistics from a data-base in northern Sweden were analyzed. The material covered every ambulance that was dispatched, 6986 times during the period of data collecting. The results show a high sensitivity but low specificity in the dispatch system. The results also indicate that over prioritization exists since most of the patients with a high acute need of an ambulance are correctly identified, while many patients without that need are also given a high priority ambulance service. Therefore the conclusions were that both over- and under prioritizations were made.
紧急救助需求通常始于拨打调度中心电话。接线员使用医学索引对调度进行优先级排序。由于救护车资源有限，调度中心的接线员所确定的优先级分级尽可能准确就显得很重要。在瑞典耶姆特兰郡，自2009年起使用一种名为METTS - A（医疗紧急分诊与治疗系统 - A）的分诊系统，对患者按照优先级进行编码。本研究的目的是分析调度中心做出的优先级分级与救护车护士评估的METTS - A优先级相比的敏感性和特异性。分析了瑞典北部一个数据库的统计数据。该资料涵盖了在数据收集期间派出的每一辆救护车，共6986次。结果显示调度系统敏感性高但特异性低。结果还表明存在过度分级的情况，因为大多数急需救护车的患者被正确识别，而许多不需要的患者也被给予了高优先级的救护车服务。因此得出的结论是，既存在过度分级也存在分级不足的情况。
