Preventable deaths following emergency medical dispatch--an audit study

Area of Science:

• Emergency medicine
• Public health
• Health services research

Background:

• Emergency Medical Communication Centre (EMCC) triage of 112 calls is challenging due to rapid decision-making with limited information.
• Investigating preventable same-day deaths among 112 callers not initially classified as high-acuity is crucial for improving emergency response.

Purpose of the Study:

• To assess the preventability and characteristics of same-day deaths following a 112 emergency call.
• To evaluate the role of EMCC triage in these outcomes.

Main Methods:

• An external audit panel of prehospital consultant anaesthesiologists reviewed patient charts and 112 call recordings.
• The panel assessed preventability (preventable, potentially preventable, non-preventable) of same-day deaths for non-high-acuity callers.
• Study included data from 75% of the Danish population over 18 months.

Main Results:

• 152 (0.16%) of 94,488 non-high-acuity 112 callers died on the same day.
• No deaths were definitively preventable by EMCC assessment.
• 18 (11.8%) deaths were potentially preventable, with 13 involving incorrect or absent dispatch protocol use.

Conclusions:

• Same-day death is infrequent among 112 callers triaged as non-high-acuity.
• Improved EMCC triage could potentially prevent a small proportion of same-day deaths.
• Adherence to dispatch protocols is vital for enhancing emergency dispatch safety.