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Medical command errors in an urban advanced life support system.

C J Holliman1, R C Wuerz, S A Meador

  • 1Division of Emergency Medicine, Milton S Hershey Medical Center, Pennsylvania State University, Hershey.

Annals of Emergency Medicine
|April 1, 1992
PubMed
Summary

Medical command errors in prehospital care, particularly failure to consider hypoglycemia, were identified. Focusing physician education on common errors can reduce the medical command error rate.

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Area of Science:

  • Emergency Medicine
  • Medical Quality Assurance

Background:

  • Online medical command is crucial for prehospital care.
  • Identifying common errors in medical command is essential for improving patient outcomes.

Purpose of the Study:

  • To identify the most common types of errors made by on-line medical command physicians.
  • To focus educational efforts for command physicians.

Main Methods:

  • Retrospective survey of prehospital advanced life support (ALS) trip sheets.
  • Review of 3,839 ALS run sheets from September 1988 to December 1990.
  • Identification and categorization of command errors by three physician reviewers.

Main Results:

  • 194 command errors were identified in 167 cases (4.4% of runs).

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  • Six error types constituted 80% of all errors, with hypoglycemia being the most common (34%).
  • The error rate decreased from 7.9% to 2.6% during the study period.

    • Conclusions:

    • Physician education should target the six identified problem areas to reduce medical command errors.
    • Ongoing quality assurance review of medical command is effective in decreasing error rates.