EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study

Area of Science:

• Emergency medicine
• Trauma care systems
• Public health policy

Background:

• Accurate dispatch priority in emergency medical communication centres (EMCC) is vital for timely trauma patient care.
• Both under-triage and over-triage of emergency medical services impact patient outcomes and system efficiency.

Purpose of the Study:

• To assess the accuracy of dispatch priority for trauma patients within the Norwegian emergency medical communication centre (EMCC).
• To identify patient demographics and injury characteristics associated with dispatch under-triage and over-triage.

Main Methods:

• A registry-based study utilizing data from the Norwegian Trauma Registry and Oslo EMCC (2019-2020).
• Inclusion of 3633 trauma patients, assessing dispatch priority using sensitivity, specificity, PPV, NPV, and accuracy.
• The New Injury Severity Score (NISS) > 15 served as the reference standard; logistic regression models analyzed influencing factors.

Main Results:

• The study reported an overall accuracy of 40%, with a dispatch under-triage rate of 15% and an over-triage rate of 89%.
• Elderly trauma patients (53%) and those with low-energy falls (51%) were frequently under-triaged.
• Female patients had higher odds of under-triage; transport-related injuries constituted 50% of over-triaged cases.

Conclusions:

• Current dispatch priority criteria in Norway's national trauma system require reassessment, particularly for elderly, female, and low-energy fall trauma patients.
• Findings suggest a need for revised criteria to ensure equitable and appropriate resource allocation for vulnerable patient groups.
• Over-triage of transport-related injuries indicates potential inefficiencies in emergency resource deployment.