Introduction: In emergency dispatching, pre-alerts are used to send responders to calls prior to getting a final dispatch code. Some studies have showed that pre-alerts can effectively reduce dispatch time for out-of-hospital cardiac arrests, potentially improving overall patient outcome. However, there is also a potential risk in running lights-and-siren on non-fully triaged calls. Although pre-alerts have been used for several years, no research studies have demonstrated its benefit, in general.

Objectives: The goal of this study was to determine the implications of pre-alerts for medical emergency calls, with regard to dispatch priorities, response units, and call cancellation and call downgrading.

Methods: This retrospective, descriptive study analyzed de-identified dispatch and EMS data from two emergency  communications centers in the USA: Johnson County Emergency Communications Center (ECC), Kansas, and Guilford County Emergency Services, North Carolina.

Results: A total of 139,815 calls were included in the study, of which 73,062 (52.3%) were downgraded, and 7,189 (5.1%) were cancelled. This indicates a waste of valuable resources and an implied increase in cost and risk. Additionally, in 20.0% of the calls, at least one response unit was cancelled, while only 1.12% were transported with high priority (lights-and-siren). A median elapsed time (-14 sec) from pre-alert to ProQA launch indicates that calls sat in the queue for median time of 14 seconds before first units were assigned.

Conclusions: The study found a significant number of cancelled units and downgraded calls. In addition, the very small percentage of calls where patients were transported with high priority indicates unnecessary pre-alerts for non-critical patients. Study findings demonstrated that calls spent a substantial amount of time in queue, and units were sent without safety/final coding information. To better establish the positive and negative impacts of pre-alerting, a controlled study

Introduction: Extrication activities at the scene of motor vehicle accidents (MVA) result in extended scene times and increase morbidity and mortality. Identifying the need for extrication-capable resources during the 911 call-taking process, and dispatching them without delay, is crucial to delivering the required response and patient care. Determining the need for extrication using the Traffic/Transport Incidents Protocol in the Medical Priority Dispatch System (MPDS®) (version 13.0 ©2000-2015, Priority Dispatch, Salt Lake City, Utah, USA) currently relies on the 911 caller’s answer to a single key question in the protocol: “Is anyone pinned (trapped)?”

Objectives: The aim of this study was to evaluate how accurate current 911 practices are in recognizing pins and entrapments resulting from MVAs. Additionally, the study sought to identify whether a Head-On (HO) MVA or an MVA with Semi-Tractor
Trailer (Semi) involvement should warrant the immediate assignment of specialized extrication resources.

Methods: This was a retrospective descriptive study of all MVA cases in three Kansas counties (Butler, Sedgwick, and Johnson), encountered from January 1, 2016, through June 30, 2017. 911 calltakers in the study population utilize the MPDS Protocols to triage MVA calls. Traffic accident data was extracted from ProQA and matched with CAD records.

Results: A total of 985 calls were analyzed, of which 218 (22.1%) required extrication and 267 (27.1%) involved Semi/HO—as documented by responders. Of the 218 cases that required extrication, 123 (56.4%) were reported pinned at dispatch and 21 (9.6%) involved Semi/head-on—15 of which were already captured by the pinned Key Question. Of the 267 cases that involved a Semi/HO, 21 (7.9%) required extrication. Of the cases that were initially reported pinned at dispatch, 123 (32.3%) required extrication by responders; and of the cases initially reported not pinned at dispatch, 59 (11.4%) required extrication by responders.

Conclusions: A “yes” answer to the protocol key question “Is anyone pinned (trapped)?” is a better predictor of extrication by responders for MVAs than is the presence of Semi/head-on involvement. Further research should examine whether High Mechanism and Major Incident determinant suffixes will capture additional extrication incidents.