Can emergency medical dispatch codes predict prehospital interventions for common 9-1-1 call types?

Area of Science:

• Emergency Medical Services
• Public Health
• Prehospital Care

Background:

• The Medical Priority Dispatch System (EMD) is crucial for categorizing emergency calls and optimizing resource allocation.
• Evaluating the predictive accuracy of EMD and non-EMD codes for prehospital interventions is essential for improving emergency response.

Purpose of the Study:

• To assess the capability of EMD and non-EMD codes in predicting prehospital medication administration and procedures.
• To determine the utility of different EMD subgroups for predicting advanced life support (ALS) interventions.

Main Methods:

• A retrospective analysis of 69,541 transported prehospital patient records from a suburban California county (2004-2006).
• Records were categorized by EMD or non-EMD status and queried for interventions: basic life support (BLS) care, IV lines, medications, and procedures.
• ALS interventions were defined as medication administration or procedures.

Main Results:

• Thirty-one EMD and non-EMD codes met inclusion criteria, representing 73% of all calls; non-EMD codes constituted 48% of the study population.
• Patients with shortness of breath, chest pain, diabetic issues, and altered mental status received the most medications.
• Procedures were rare (0.9%), primarily advanced airways; ALS interventions varied across EMD categories, with some complaints showing higher rates than others.

Conclusions:

• The EMD system demonstrated only moderate effectiveness in predicting the need for ALS interventions.
• Limited differences in ALS rates among subgroups within the same complaint category raise questions about the utility of these distinctions.
• Non-EMD codes represent a significant portion of emergency calls and warrant inclusion in future predictive analyses.