title: [Optimization of use of prehospital emergency physicians after new dispatch and guidance instructions].
abstract: BACKGROUND
  Correct use of prehospital medical competence requires optimal dispatch. Based on the severity gauge Severity of Injury/Illness Index (SIII) which grades injury/illness into eight levels, we examined the effect of implementing new dispatch and guidance instructions in the emergency call centre.
  
  
  METHODS
  From the local Prehospital Database we have withdrawn data from 1st August 2000 to 31st December 2005. On 1st August 2003 new dispatch and guidance instructions were implemented with a graded allocation of prehospital resources. It is hereby possible to dispatch 1) an ambulance + prehospital emergency physician (PEP); 2) an ambulance; or refer to 3) self care or alternative transportation.
  
  
  RESULTS
  During the study 10,585 patients were attended by a PEP. After implementing the new dispatch and guidance instructions we experienced a total increase of five per cent in the four most severe SIII-groups. A total of 189 patients were transferred to the relevant groups. These changes are significant with p < 0,001 (chi2-test).
  
  
  CONCLUSIONS
  By implementing more graded dispatch and guidance instructions in the emergency call centre it is possible to optimise the use of the PEP.
authors.affiliation: Region Nordjylland. mida@rn.dk
authors.forename: Michael Kanstrup
authors.initials: MK
authors.lastname: Dahl
authors.forename: Niels Dalsgaard
authors.initials: ND
authors.lastname: Nielsen
authors.forename: Flemming
authors.initials: F
authors.lastname: Knudsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000592:standards / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data; D015277:Hotlines / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012648:Self Care; D012720:Severity of Illness Index; D014187:Transportation of Patients