PERFORMANCE OF A SYSTEM TO DETERMINE EMS DISPATCH PRIORITIES

Inappropriate use of emergency medical services (EMS) for nonemergenci es strains EMS resources and limits efficiency, Protocol-driven dispat ch systems attempt to correct the imbalance that exists between demand and available resources by prioritizing 911 calls. This study compare d dispatch priority decisions with apparent patient need, based on eme rgency department (ED) presentation, by matching 320 ED charts with co rresponding EMS dispatch and run information, The priorities assigned by the system based on dispatch information were compared with those a ssigned by a three-member panel of physicians based on ED presentation . The physicians and dispatchers agreed on the need for advanced life support (ALS) versus basic life support (BLS) transport 74% of the tim e. There was only 43% agreement on the more detailed 4-level classific ation system. The system assigned the highest level of dispatch utiliz ing combined ALS and first responders to a significantly greater degre e than did the physicians, It was concluded that protocol systems for setting dispatch priorities utilize EMS resources to a higher degree t han actually required based on ED presentation. Copyright (C) 1996 by W.B. Saunders Company.