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Sensitivity and Specificity of the Medical Priority Dispatch System in Detecting Cardiac Arrest Emergency Calls in Melbourne

Published online by Cambridge University Press:  28 June 2012

Julie Flynn ,
Frank Archer  and
Amee Morgans
Julie Flynn
Affiliation:
Centre for Ambulance and Paramedic Studies, Monash University, Frankston, Australia
Frank Archer
Affiliation:
Centre for Ambulance and Paramedic Studies, Monash University, Frankston, Australia
Amee Morgans*
Affiliation:
Centre for Ambulance and Paramedic Studies, Monash University, Frankston, Australia
*
Amee Morgans Research Fellow Centre for Ambulance and Paramedic Studies Monash University PO Box 527 Frankston VIC 3199 Australia E-mail:Amee.Morgans@med.monash.edu.au
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Abstract

Introduction:

In Australia, cardiac arrest kills 142 out of every 100,000 people each year; with only 3–4% of out-of-hospital patients with cardiac arrest in Melbourne surviving to hospital discharge. Prompt initiation of cardiopulmonary resuscitation (CPR), defibrillation, and advanced cardiac care greatly improves the chances of survival from cardiac arrest. A critical step in survival is identifying by the emergency ambulance dispatcher potential of the probability that the person is in cardiac arrest. The Melbourne Metropolitan Ambulance Service (MAS) uses the computerized call-taking system, Medical Priority Dispatch System (MPDS), to triage incoming, emergency, requests for ambulance responses. The MPDS is used in many emergency medical systems around the world, however, there is little published evidence of the system's efficacy.

Objective:

This study attempts to undertake a sensitivity/specificity analysis to determine the ability of MPDS to detect cardiac arrest.

Methods:

Emergency ambulance dispatch records of all cases identified as suspected cardiac arrest by MPDS were matched with ambulance, patient-care records and records from the Victorian Ambulance Cardiac Arrest Registry to determine the number of correctly identified cardiac arrests. Additionally, cases that had cardiac arrests, but were not identified correctly at the point of call-taking, were examined. All data were collected retrospectively for a three-month period (01 January through 31 March 2003).

Results:

The sensitivity of MPDS in detecting cardiac arrest was 76.7% (95% confidence interval (CI): 73.6%–79.8%) and specificity was 99.2% (95% CI: 99.1–99.3%). These results indicate that cardiac arrests are correctly identified in 76.7% of cases.

Conclusion:

Although the system correctly identified 76.7% of cardiac arrest cases, the number of false negatives suggests that there is room for improvement in recognition by MPDS to maximize chances for survival in out-of-hospital cardiac arrest. This study provides an objective and comprehensive measurement of the accuracy of MPDS cardiac-arrest detection in Melbourne, as well as providing a baseline for comparison with subsequent changes to the MPDS.

Keywords

ambulancecardiac arrestcomputer-aided dispatchresource allocation
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 21 , Issue 2 , April 2006 , pp. 72 - 76
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2006

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References

1Newman, M: The chain of survival revisited: The emergence of early recognition as the unsung vital link. JEMS 1998;23((5):46–56.Google ScholarPubMed
2Farand, L, Leprohon, J, Kalina, M, Champagne, F, Contandriopoulos, A, Preker, A: The role of protocols and professional judgement in emergency medical dispatching. Eur J Emerg Med 1995;2((3):136–148.Google Scholar
3Clawson, JJ, Martin, RL, Cady, GA, Maio, R: The wake effect: Emergency vehicle-related collisions. Prehosp Disast Med 1997;12((4):274–277.Google Scholar
4Maguire, B, Hunting, KL, Smith, GS, Levick, NR: Occupational fatalities in emergency medical services: A hidden crisis. Ann Emerg Med 2002;40((6):625–632.CrossRefGoogle ScholarPubMed
5Anonymous: Ambulance crash-related injuries among emergency medical services workers—United States, 1991-2002. JAMA 2003;289(13):1628–1629.Google Scholar
6Smith, K, Peeters, A, McNeil, J: Results from the first 12 months of a fire first-responder program in Australia. Resuscitation 2001;49:143–150.Google Scholar
7Bernard, S: Outcome from pre-hospital cardiac arrest in Melbourne, Australia. Emerg Med 1998;10:25–29.Google Scholar
8Waalewijn, RA, de Vos, R, Koster, RW: Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: Results from the Amsterdam resuscitation study (ARREST) in ‘Utstein’ style. Resuscitation 1998;38((3):157–167.CrossRefGoogle ScholarPubMed
9Metropolitan Ambulance Service, Metropolitan Ambulance Service Website, Available at http://www.ambulance-vic.com.au/mas_index.html. Accessed 27 May 2003.Google Scholar
10Wilson, S, Cooke, M, Morrell, R, Bridge, P, Allan, T: A systematic review of the evidence supporting the use of priority dispatch of emergency ambulances. Prehosp Emerg Care 2002;6((1):42–49.CrossRefGoogle ScholarPubMed
11Bailey, ED, O'Connor, RE, Ross, RW: The use of emergency medical dispatch protocols to reduce the number of inappropriate scene responses made by advanced life support personnel. Prehosp Emerg Care 2000;4((2):186–189.CrossRefGoogle ScholarPubMed
12Holmberg, T, Joyce, S: Appropriateness of EMS response in a priority dispatch system. Ann Emerg Med 1998;32(3):111. Abstract.Google Scholar
13Palumbo, L, Kubincanek, J, Emerman, C., Jouriles, N, Cydulka, R, Shade, B: Performance of a system to determine EMS dispatch priorities. Am J Emerg Med 1996;14((4):388–390.CrossRefGoogle ScholarPubMed
14Slovis, CM, Carruth, TB, Seitz, WJ, Thomas, CM, Elsea, WR. A priority dispatch system for emergency medical services. Ann Emerg Med 1985;14((11):1055–1060.CrossRefGoogle ScholarPubMed
15Nicholl, J, Coleman, P, Parry, G, Turner, J, Dixon, S: Emergency priority dispatch systems: A new era in the provision of ambulance services in the UK. Prehosp Emerg Care 1999; 3:71–75.Google Scholar
16Garza, AG, Gratton, MC, Chen, JJ, Carlson, B: The accuracy of predicting cardiac arrest by emergency medical services dispatchers: The calling party effect. Acad Emerg Med 2003;10((9):955–960.CrossRefGoogle ScholarPubMed
17FitzGerald, G, Sayre, M, Kazunas, G, Liu, T: Can medical call-takers accurately identify cardiac arrest? Acad Emerg Med 1998;5:387. Abstract.Google Scholar
18Heward, A, Damiani, M, Hartley-Sharpe, C: Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J 2004;21:115–118.CrossRefGoogle ScholarPubMed