Handling of drug-related emergencies: an evaluation of emergency medical dispatch.
OBJECTIVE
Documenting the quality of emergency dispatch centres handling of emergency calls regarding intoxicated unconscious patients.


METHODS
Interview with eight emergency dispatch centre directors and a nationwide survey among 313 dispatchers in Norway were performed. In addition, a customized scoring system was used to evaluate dispatcher log recordings of real cases. The recordings were compared with information from corresponding ambulance records.


RESULTS
Ninety-nine percent of the dispatchers stated that they used the Norwegian protocol for medical emergencies and 89% of them found it useful. The interviews, the survey, and the recordings, however, documented frequent deviation from the protocol. This instructs ambulance dispatch for any unconscious patient, but 21% stated that they would not dispatch any resource for an unconscious patient without further survey in alcohol-related cases. This was significantly more often (P<0.05) than for the narcotic, combination and prescription - drug-related cases with 4, 10 and 7%, respectively. The recordings revealed deviation from the protocol with dispatchers only determining the patients' level of consciousness and respiratory status in 64 and 70% of the cases, respectively. For 16% of the cases, the dispatcher did not ask the caller about consciousness at all, even though these patients later were found with reduced consciousness.


CONCLUSIONS
On the basis of the interviews and the survey, cases were handled according to guidelines. The log recordings, however, disclosed deviation from the protocol. Alcohol intoxication was associated with higher rate of deviation from the protocol compared with other intoxications.
Tonje
Lorem
L
Department of Research and Development, Norwegian Air Ambulance Foundation, Drobak, Norway. tonie.lorem@medisin.uio.no
Elisabeth
Saether
S
Lars
Wik
W
D000437:Alcoholism; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D003625:Data Collection; D004631:Emergency Medical Service Communication Systems / Q000592:standards*; D019983:Guideline Adherence; D006801:Humans; D007407:Interviews as Topic; D009664:Norway; D019966:Substance-Related Disorders