A Dispatch Screening Tool to Identify Patients at High Risk for COVID-19 in the Prehospital Setting

Area of Science:

• Emergency Medicine
• Infectious Disease Surveillance
• Public Health

Background:

• Emergency Medical Services (EMS) dispatchers utilize screening tools to identify high-risk coronavirus disease 2019 (COVID-19) patients.
• Balancing personnel protection and personal protective equipment (PPE) conservation is critical.
• Limited literature exists on the efficacy of prehospital COVID-19 screening tools.

Purpose of the Study:

• To determine the positive and negative predictive values of an emergency infectious disease surveillance tool for COVID-19 detection.
• To assess the impact of positive screening on PPE usage by EMS crews.

Main Methods:

• Retrospective chart review of prehospital care reports and hospital electronic health records.
• Analysis of 911 calls with documented positive COVID-19 screen or positive test results.
• Evaluation of dispatch screening data, COVID-19 test outcomes, and PPE adherence.

Main Results:

• The screening tool demonstrated a sensitivity of 74.9% and specificity of 67.7%.
• Positive predictive value was 4.5%, while negative predictive value was high at 99.3%.
• Shortness of breath was the most common positive screening symptom; skilled nursing facility patients were the most identified high-risk group, though most positive tests were not from this group.

Conclusions:

• The EMS dispatch screening tool exhibits a high negative predictive value but moderate sensitivity.
• Caution is advised when using the tool to guide EMS PPE usage.
• Clinical judgment remains essential and may override screening status.