Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England
Abstract Background Helicopter Emergency Medical Services (HEMS) are a limited and expensive resource, and should be intelligently tasked. HEMS dispatch was identified as a key research priority in 2011, with a call to identify a ‘general set of criteria with the highest discriminating potential’. H...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-023-01094-w |
| _version_ | 1797801217361969152 |
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| author | Christopher T. Edmunds Kate Lachowycz Sarah McLachlan Andrew Downes Andrew Smith Rob Major Edward B. G. Barnard |
| author_facet | Christopher T. Edmunds Kate Lachowycz Sarah McLachlan Andrew Downes Andrew Smith Rob Major Edward B. G. Barnard |
| author_sort | Christopher T. Edmunds |
| collection | DOAJ |
| description | Abstract Background Helicopter Emergency Medical Services (HEMS) are a limited and expensive resource, and should be intelligently tasked. HEMS dispatch was identified as a key research priority in 2011, with a call to identify a ‘general set of criteria with the highest discriminating potential’. However, there have been no published data analyses in the past decade that specifically address this priority, and this priority has been reaffirmed in 2023. The objective of this study was to define the dispatch criteria available at the time of the initial emergency call with the greatest HEMS utility using a large, regional, multi-organizational dataset in the UK. Methods This retrospective observational study utilized dispatch data from a regional emergency medical service (EMS) and three HEMS organisations in the East of England, 2016–2019. In a logistic regression model, Advanced Medical Priority Dispatch System (AMPDS) codes with ≥ 50 HEMS dispatches in the study period were compared with the remainder to identify codes with high-levels of HEMS patient contact and HEMS-level intervention/drug/diagnostic (HLIDD). The primary outcome was to identify AMPDS codes with a > 10% HEMS dispatch rate of all EMS taskings that would result in 10–20 high-utility HEMS dispatches per 24-h period in the East of England. Data were analysed in R, and are reported as number (percentage); significance was p < 0.05. Results There were n = 25,491 HEMS dispatches (6400 per year), of which n = 23,030 (90.3%) had an associated AMPDS code. n = 13,778 (59.8%) of HEMS dispatches resulted in patient contact, and n = 8437 (36.6%) had an HLIDD. 43 AMPDS codes had significantly greater rates of patient contact and/or HLIDD compared to the reference group. In an exploratory analysis, a cut-off of ≥ 70% patient contact rate and/or ≥ 70% HLIDD (with a > 10% HEMS dispatch of all EMS taskings) resulted in 17 taskings per 24-h period. This definition derived nine AMPDS codes with high HEMS utility. Conclusion We have identified nine ‘golden’ AMPDS codes, available at the time of initial emergency call, that are associated with high-levels of whole-system and HEMS utility in the East of England. We propose that UK EMS should consider immediate HEMS dispatch to these codes. |
| first_indexed | 2024-03-13T04:47:05Z |
| format | Article |
| id | doaj.art-050d7431356d45f1acd86597f946375c |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-03-13T04:47:05Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-050d7431356d45f1acd86597f946375c2023-06-18T11:23:34ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-06-0131111010.1186/s13049-023-01094-wNine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of EnglandChristopher T. Edmunds0Kate Lachowycz1Sarah McLachlan2Andrew Downes3Andrew Smith4Rob Major5Edward B. G. Barnard6Department of Research, Audit, Innovation, and Development, East Anglian Air AmbulanceDepartment of Research, Audit, Innovation, and Development, East Anglian Air AmbulanceEssex & Herts Air Ambulance TrustDepartment of Research, Audit, Innovation, and Development, East Anglian Air AmbulanceMagpas Air AmbulanceDepartment of Research, Audit, Innovation, and Development, East Anglian Air AmbulanceDepartment of Research, Audit, Innovation, and Development, East Anglian Air AmbulanceAbstract Background Helicopter Emergency Medical Services (HEMS) are a limited and expensive resource, and should be intelligently tasked. HEMS dispatch was identified as a key research priority in 2011, with a call to identify a ‘general set of criteria with the highest discriminating potential’. However, there have been no published data analyses in the past decade that specifically address this priority, and this priority has been reaffirmed in 2023. The objective of this study was to define the dispatch criteria available at the time of the initial emergency call with the greatest HEMS utility using a large, regional, multi-organizational dataset in the UK. Methods This retrospective observational study utilized dispatch data from a regional emergency medical service (EMS) and three HEMS organisations in the East of England, 2016–2019. In a logistic regression model, Advanced Medical Priority Dispatch System (AMPDS) codes with ≥ 50 HEMS dispatches in the study period were compared with the remainder to identify codes with high-levels of HEMS patient contact and HEMS-level intervention/drug/diagnostic (HLIDD). The primary outcome was to identify AMPDS codes with a > 10% HEMS dispatch rate of all EMS taskings that would result in 10–20 high-utility HEMS dispatches per 24-h period in the East of England. Data were analysed in R, and are reported as number (percentage); significance was p < 0.05. Results There were n = 25,491 HEMS dispatches (6400 per year), of which n = 23,030 (90.3%) had an associated AMPDS code. n = 13,778 (59.8%) of HEMS dispatches resulted in patient contact, and n = 8437 (36.6%) had an HLIDD. 43 AMPDS codes had significantly greater rates of patient contact and/or HLIDD compared to the reference group. In an exploratory analysis, a cut-off of ≥ 70% patient contact rate and/or ≥ 70% HLIDD (with a > 10% HEMS dispatch of all EMS taskings) resulted in 17 taskings per 24-h period. This definition derived nine AMPDS codes with high HEMS utility. Conclusion We have identified nine ‘golden’ AMPDS codes, available at the time of initial emergency call, that are associated with high-levels of whole-system and HEMS utility in the East of England. We propose that UK EMS should consider immediate HEMS dispatch to these codes.https://doi.org/10.1186/s13049-023-01094-wAir ambulancesEmergency medical dispatchEmergency medical servicesPrehospital emergency care |
| spellingShingle | Christopher T. Edmunds Kate Lachowycz Sarah McLachlan Andrew Downes Andrew Smith Rob Major Edward B. G. Barnard Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Air ambulances Emergency medical dispatch Emergency medical services Prehospital emergency care |
| title | Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England |
| title_full | Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England |
| title_fullStr | Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England |
| title_full_unstemmed | Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England |
| title_short | Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch—a retrospective, multi-organisational study in the East of England |
| title_sort | nine golden codes improving the accuracy of helicopter emergency medical services hems dispatch a retrospective multi organisational study in the east of england |
| topic | Air ambulances Emergency medical dispatch Emergency medical services Prehospital emergency care |
| url | https://doi.org/10.1186/s13049-023-01094-w |
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