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Emergency department telephone advice.

V P Verdile1, P M Paris, R D Stewart

  • 1Division of Emergency Medicine, University of Pittsburgh School of Medicine, Pennsylvania.

Annals of Emergency Medicine
|March 1, 1989
PubMed
Summary

Emergency departments (EDs) often provide telephone medical advice. A study found that advice given by some EDs was inconsistent and potentially unsafe, with many staff failing to ask crucial questions or advise calling emergency services for serious conditions like potential myocardial ischemia.

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Area of Science:

  • Emergency Medicine
  • Public Health
  • Medical Communication

Background:

  • Emergency departments (EDs) frequently field telephone inquiries for medical advice.
  • The consistency and accuracy of this advice are critical for patient safety.
  • Previous assessments of telephone triage protocols in ED settings are limited.

Purpose of the Study:

  • To evaluate the consistency and accuracy of medical advice provided by EDs to callers with potential myocardial ischemia.
  • To identify potential deficiencies in telephone triage and advice-giving practices within emergency departments.

Main Methods:

  • A simulated patient scenario of potential myocardial ischemia was presented via telephone to 46 EDs.
  • A research assistant made the calls, documenting the advice received.

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  • Data collected included the nature of the respondent, questions asked, and recommendations given.

    • Main Results:

    • Nine percent of calls were handled solely by ED unit secretaries.
    • 56% of ED respondents failed to inquire about the patient's symptoms or chief complaint.
    • Only 4 EDs advised the caller to contact emergency medical services (e.g., call 911) for immediate transport.

    Conclusions:

    • Telephone medical advice provided by some EDs is non-standardized.
    • Current practices may be inadequate, potentially compromising patient welfare in critical situations.
    • There is a need for improved training and standardized protocols for ED telephone triage.