Prehospital critical care dispatch: a scoping review (PHASE)

Area of Science:

• Emergency Medicine
• Critical Care
• Health Services Research

Background:

• Prehospital critical care (PHCC) dispatch is crucial for allocating specialized resources to critically ill or injured patients.
• Existing evidence on optimizing PHCC dispatch needs examination to identify research gaps and future priorities.

Purpose of the Study:

• To conduct a scoping review of existing evidence on optimizing prehospital critical care dispatch.
• To identify research gaps and propose priorities for future investigation in PHCC dispatch.

Main Methods:

• Systematic search of CINAHL, PubMed, EMBASE, and CENTRAL databases (January 2004 - October 2024).
• Inclusion of all study types focusing on global PHCC asset dispatch.

Main Results:

• 39 studies were included, exhibiting diverse designs, settings, and focuses (e.g., trauma vs. medical).
• Outcomes assessed dispatch factors, physiological and temporal variables, using advanced interventions and survival metrics.
• Helicopter Emergency Medical Services (HEMS) and Physician-based HEMS (P-HEMS) were commonly studied, with inconsistent predictive accuracy for dispatch criteria, particularly in older trauma patients.

Conclusions:

• Variability exists in PHCC dispatch models, staffing, and outcome measures.
• Clinician involvement enhances dispatch accuracy, but the role of cognitive tools requires further study.
• Future research should focus on prospective studies, addressing ethical/logistical challenges, expanding research in low- and middle-income countries, and validating new technologies like automated crash notifications.