Response Level Determinants Derived from 9-1-1 Callers Versus On-Scene Paramedics
Brett A. Patterson, NREMT-P* CareLine of Florida, Largo, Florida USA

Hypothesis: Response determinant level selection by properly trained emergency medical dispatchers after 9-1-1, second-party caller interrogation, are accurate as compared to response determinants derived from the same interrogation sequence of the first-arriving paramedic after personal patient contact.

Methods: Certified emergency medical dispatchers used the Advanced Medical Priority Dispatch System‘ to interrogate 9-1-1 callers and assign response determinants to 9-1-1 calls received. The first-arriving paramedics then were interrogated retrospectively using the same interrogation sequence. Field providers were blinded to the response determinants selected by the dispatchers and responded with lights and sirens to all calls. Real-time quality control audits were performed on all interrogations to ensure protocol compliance. The response determinants selected by the original dispatchers then were compared to determinants derived from interrogation of the on-scene paramedics.

Results: Results are illustrated below:

Match Over-Triage Under-Triage

Volume: 292-158- 22

Percent: 0.617-0.336-0.047

Conclusion: The study results tend to support the use of the priority dispatch reference system to assign response modes, as 0.953 percent of cases were either matched or over-triaged. This assumes that the response levels assigned to the response determinants are appropriate for the patient conditions found on- scene. With regard to resource allocation, an over-triage rate of 0.336 appears conservative and certainly errs on the side of the patient.