Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
Ospedale Maggiore Carlo Alberto Pizzardi, Emergency Department, Regional Program, Bologna, Italy.
Prehosp Disaster Med. 2021 Apr;36(2):195-201. doi: 10.1017/S1049023X21000030. Epub 2021 Feb 1.
The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched.
This study aimed to evaluate the effects on the appropriateness of ALS teams' intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation.
This was a retrospective before-after observational study.
Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018).
A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented.
Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed.
The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced.
The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.
在紧急医疗服务（EMS）中，高级生命支持（ALS）团队的派遣仍然是院前紧急物流中一个研究甚少的方面。2015 年，艾米利亚-罗马涅紧急行动中心（EE-EOC）的派遣算法得到实施，当派遣具备即时生命支持（ILS）技能的车辆进行高优先级干预时，根据对已派遣车辆的分类，将 ALS 团队的派遣从初级改为二级。
本研究旨在评估 ALS 团队干预的适当性及其使用时间，并比较算法实施的敏感性和特异性。
这是一项回顾性前后观察研究。
纳入 EE-EOC 管理的涉及救护车和/或 ALS 团队的初级派遣。根据干预年份（2013-2014 年与 2017-2018 年）创建了两个组。
对由 ILS 团队管理的高优先级派遣实施 ALS 团队从初级派遣改为二级派遣的转变。
审查了 ALS 团队干预的适当性、ALS 车辆的总任务时间以及算法的敏感性和特异性。
派遣标准的修订和 ALS 团队的两级派遣的扩展显著提高了 ALS 干预的适当性，并减少了 ALS 可用的全球任务时间和高优先级无 ALS 派遣的数量。
