INCREASING THE EFFICIENCY OF EMERGENCY MEDICAL-SERVICES BY USING CRITERIA-BASED DISPATCH

Study objectives: To determine whether criteria based dispatch (CBD) i mproved the efficiency of the emergency medical services system. Desig n: A before and after design was used to measure effects of CBD. Data were reviewed from medical reports from January 1986 through June 1992 . Setting: King County, Washington, excluding the city of Seattle. Par ticipants: Residents who called 911 to report a medical emergency. Int erventions: Emergency medical dispatching (EMD), basic life support (B LS), and advanced life support (ALS). Results: Findings show a decreas e in ALS responses for two tracer conditions that medical control phys icians determined not require ALS intervention. The percentage of febr ile seizures in which paramedics responded decreased from 41% to 21% ( P<.001). The percentage of cerebrovascular accidents in which paramedi cs responded decreased from 41% to 28% (P<.001). CBD led to a decrease , from 4.7% to 3.8% (P<.001), in frequency of requests by BLS units fo r dispatch of ALS units. There was no increase in the time required to dispatch each call. Conclusion: CBD increased the efficiency of the E MS system by significantly reducing ALS responses to incidents not req uiring ALS intervention and reducing requests by BLS units for dispatc h of ALS units while maintaining a consistent time from receipt of cal l to dispatch.