title: Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders.
abstract: BACKGROUND
  Shortening response time to an emergency call leads to the success of resuscitation by chest compression and defibrillation. However, response by ambulance or fire truck is not fast enough for resuscitation in Japan. In rural areas, response times can be more than 10 minutes. One possible way to shorten the response time is to establish a system of first responders (eg, police officers or firefighters) who are trained appropriately to perform resuscitation. Another possible way is to use a system of Community First Responders (CFRs) who are trained neighbors. At present, there are no call triage protocols to decide if dispatchers should activate CFRs.
  
  
  OBJECTIVE
  The aim of this study was to determine the predictability to detect if dispatchers should activate CFRs.
  
  
  METHODS
  Two CFR call triage protocols (CFR protocol Ver.0 and Ver.1) were established. The predictability of CFR protocols was examined by comparing the paramedic field reports. From the results of sensitivity of CFR protocol, the numbers of annual CFR activations were calculated. All data were collected, prospectively, for four months from October 1, 2012 through January 31, 2013.
  
  
  RESULTS
  The ROC-AUC values appear slightly higher in CFR protocol Ver.1 (0.857; 95% CI, 79.8-91.7) than in CFR protocol Ver.0 (0.847; 95% CI, 79.0-90.3). The number of annual CFR activations is higher in CFR protocol Ver.0 (7.47) than in CFR protocol Ver.1 (5.45).
  
  
  CONCLUSIONS
  Two call triage protocols have almost the same predictability as the Medical Priority Dispatch System (MPDS). The study indicates that CFR protocol Ver.1 is better than CFR protocol Ver.0 because of the higher predictability and low number of activations. Also, it indicates that CFRs who are not medical professionals can respond to a patient with cardiac arrest.
authors.affiliation: 1Department of Sport and Medical Science Paramedic Course, Faculty of Medical Technology,Teikyo University,Itabashi,Tokyo,Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Narikawa
authors.affiliation: 2School of Medicine,Department of Emergency Medicine,Trauma and Resuscitation Center,Teikyo University,Itabashi,Tokyo,Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakamoto
authors.affiliation: 3National Research Institute of Fire and Disaster of Japan,Tyofu,Tokyo,Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Kubota
authors.affiliation: 4Department of Emergency and Critical Care Medicine,Jichi Medical University,Shimotsuke,Tochigi,Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzukawa
authors.affiliation: 4Department of Emergency and Critical Care Medicine,Jichi Medical University,Shimotsuke,Tochigi,Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Yonekawa
authors.affiliation: 4Department of Emergency and Critical Care Medicine,Jichi Medical University,Shimotsuke,Tochigi,Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamashita
authors.affiliation: 5Post-graduate School,Jichi Medical University,Shimotsuke,Tochigi,Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Toyokuni
authors.affiliation: 6Hiroshima International University,Department of Clinical Engineering,Higashi-Hiroshima,Hiroshima,Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: 7Administration Division,Haga Fire Department,Mooka,Tochigi,Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: 7Administration Division,Haga Fire Department,Mooka,Tochigi,Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Iijima
mesh_terms: D017598:Efficiency, Organizational; D004631:Emergency Medical Service Communication Systems / Q000592:standards / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014218:Triage / Q000592:standards / Q000706:statistics & numerical data