Browse > Article
http://dx.doi.org/10.5392/JKCA.2012.12.12.345

Utility of the Dispatch Protocol to Triage the Emergency Patients who presented with Symptoms of Stroke or Chest Pain  

Cho, Suck-Ju (부산대학교병원)
An, Byeung-Ki (국립중앙의료원 중앙응급의료센터)
Park, Jae-Yong (경북대학교 의과대학 예방의학교실)
Publication Information
Abstract
Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.
Keywords
Triage; Chest Pain; Stroke;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 M. Lewin, S. Hori, and N. Aikawa, "Emergency medical services in Japan: an opportunity for the rational development of pre-hospital care and research," J. of Emerg Med, Vol.28, No.2, pp.237-41, 2005.   DOI   ScienceOn
2 T. Schmidt, D. Cone, and N. Mann, "Criteria currently used to evaluate dispatch triagesystems: where do they leave us?," J. of Prehosp Emerg Care, Vol.8, No.2, pp.126-129, 2004.
3 http://www.emergencydispatch.org/articles/dispatchprioritytraining1.htm
4 J. Clawson, C. Olola, A. Heward, G. Scott, and B. Patterson, "Accuracy of emergency me dical dispatchers' subjective ability to identify when higher dispatch levels are warranted over a Medical Priority Dispatch System automated protocol's recommended coding based on paramedic outcome data," J. of Emerg Med, Vol.24, No.5, pp.560-563, 2007.   DOI   ScienceOn
5 K. Neely, R. Norton, and T. Schmidt, "The strength of specific EMS dispatcher questions for identifying patients with important clinical field findings," J. of Prehosp Emerg Care, Vol.4, No.4, pp.322-326, 2000.   DOI   ScienceOn
6 M. Feldman, P. Verbeek, D. Lyons, S. Chad, A. Craig, and B. Schwartz, "Comparison of the medical priority dispatch system to an out-of-hospital patient acuity score," J. of Acad Emerg Med, Vol.13, No.3, pp.954-960, 2006.   DOI
7 강영호, 윤석준, 강길원, 김창엽, 유근영, 신영수, "델파이법을 적용한 암연구수준의 평가", 예방의학회지, 제4권, 제31호, pp.844-856, 1998.   과학기술학회마을
8 김용권, 류진호, 문원식, 전병조, 허탁, 민용일, "119 구급대를 통해 내원한 응급환자의 분석", 대한응급의학회지, 제11권, 제2호, pp,190-195, 2000.
9 R. Derlet and J. Richards, "Overcrowding in the nation's emergency departments: complex causes and disturbing effects," J. of Ann Emerg Med, Vol.35, No.1, pp.63-68, 2000.   DOI   ScienceOn
10 박인철, 이경룡, 이한식, "구급차를 이용한 응급환자의 중증도 분류", 대한응급의학회지, 제7권, 제1호, pp.104-111, 1996.
11 P. Ramanujam, K. Guluma, E. Castillo, M. Chacon, M. Jensen, and E. Patel, "Accuracy of stroke recognition by emergency medical dispatchers and paramedics—San Diego experience," J. of Prehosp Emerg Care, Vol.12, No.3, pp.307-313, 2008.   DOI   ScienceOn
12 신태건, 송진우, 송형곤, 홍종근, "응급실 다방문 환자의 임상적 특성에 관한 연구", 대한응급의학회지, 제22권, 제1호, pp.86-92, 2011.
13 A. Garza, M. Gratton, J. McElroy, D. Lindholm, and E. Glass, "The association of dispatch prioritization and patient acuity," J. of Prehosp Emerg Care, Vol.12, No.1, pp.24-29, 2008.   DOI   ScienceOn
14 A. Garza, M. Gratton, J. Chen, and B. Carlson, "The accuracy of predicting cardiac arrest by emergency medical services dispatchers: the calling party effect," J. of Acad Emerg Med, Vol.10, No.9, pp.955-960, 2003.   DOI   ScienceOn
15 L. Culley, D. Henwood, J. Clark, M. Eisenberg, and C. Horton, "Increasing the efficiency of emergency medical services by using criteria based dispatch," J. of Ann Emerg Med, Vol.24, No.5, pp.867-872, 1994.   DOI   ScienceOn
16 N. Engl, "The National Institute of Neurological Disorders, and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acuteischemic stroke," J. of Med, Vol.333, No.10, pp.1581-1587, 1995.
17 D. Desilvey, "Times to treatment in transfer patients undergoing primary percutaneous coronary intervention in the United States," J. of Geriatr Cardiol, Vol.14, No.4, pp.203-204, 2005.   DOI   ScienceOn
18 E. Antman, M Hand, P. Armstrong, E. Bates, L. Green, and L. Halasyamani, "2007 Focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines," J. of Circulation, Vol.117, No.2, pp.296-329, 2008.   DOI   ScienceOn
19 E. Bailey, R. O'Connor, and R. Ross, "The use of emergency medical dispatch protocols to reduce the number of inappropriate scene responses made by advanced life support personnel", J of. Prehosp Emerg Care, Vol.4, No.2, pp.186-189, 2000.   DOI   ScienceOn
20 J. Dunford, "Emergency medical dispatch," J. of Emerg Med Clin North Am, Vol.20, No.2, pp.859-875, 2002.   DOI
21 이영호, 장희태, 이병문, "홈 헬스를 위한 메디컬 센서노드의 분산보관 프로토콜", 한국콘텐츠학회논문지, 제12권, 제1호, pp.80-90, 2012.   과학기술학회마을   DOI   ScienceOn
22 신동영, 이병문, "효과적인 응급대응을 위한 소형선박의 위치기반 스마트케어시스템", 한국콘텐츠학회논문지, 제12권, 제8호, pp.59-68, 2012.   과학기술학회마을   DOI   ScienceOn