EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study
Abstract Background Dispatch priority assessments in emergency medical communication centres (EMCC) play a crucial role in determining how quickly emergency medical services reach the scene after an injury. Consequently, accurate prioritization of resources is important in ensuring that patients req...
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s13049-025-01387-2 |
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| author | Inger Marie Waal Nilsbakken Torben Wisborg Stephen Sollid Elisabeth Jeppesen |
| author_facet | Inger Marie Waal Nilsbakken Torben Wisborg Stephen Sollid Elisabeth Jeppesen |
| author_sort | Inger Marie Waal Nilsbakken |
| collection | DOAJ |
| description | Abstract Background Dispatch priority assessments in emergency medical communication centres (EMCC) play a crucial role in determining how quickly emergency medical services reach the scene after an injury. Consequently, accurate prioritization of resources is important in ensuring that patients requiring specialized care receive timely treatment to optimize their outcome. Both dispatch under-triage, where patients with severe injuries receive low priority, and dispatch over-triage, which unnecessarily allocates limited emergency resources, can impact patient outcomes and system efficiency. This study aimed to assess dispatch priority in the EMCC for a cohort of trauma patients in Norway. Methods This registry-based study included 3633 patients from the Norwegian Trauma Registry and Oslo EMCC during 2019–2020. We assessed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false negative rate (dispatch under-triage rate), false positive rate (dispatch over-triage rate), and accuracy of dispatch priority. The New Injury Severity Score (NISS) > 15 was used as a reference standard. Differences in dispatch priority assessments were analysed using descriptive statistics. Two logistic regression models were used to examine the relationship between dispatch priority and factors associated with the assessment. Results Our analysis revealed the following dispatch metrics: sensitivity (85%), specificity (11%), PPV (38%), NPV (53%), dispatch under-triage rate (15%), dispatch over-triage rate (89%), and overall accuracy (40%). Under-triaged dispatches frequently involved elderly trauma patients (53%) and patients with low-energy falls (51%). Elderly trauma patients had more than 7 times the odds of receiving inappropriately low dispatch priority compared to children and nearly twice the odds compared to adults, after accounting for factors such as injury mechanism. Similarly, female patients had 81% higher odds of receiving inappropriately low dispatch priority compared to male patients, when controlling for factors like age and injury mechanism. Among over-triaged dispatches, transport-related injuries accounted for half of the cases (50%). Conclusion This study primarily evaluated the national trauma system’s dispatch priority criteria. Our findings indicate that elderly trauma patients, those with low-energy falls and female patients were often assigned inadequate priority by current criteria, indicating a need to reassess the current criteria to better address these patients’ needs. Additionally, we found that patients involved in transport-related accidents were overrepresented among over-triaged dispatches, highlighting a potential misallocation of resources. |
| format | Article |
| id | doaj-art-7267291c1ca04f1fbc674fde6dbb7dd9 |
| institution | Kabale University |
| issn | 1757-7241 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj-art-7267291c1ca04f1fbc674fde6dbb7dd92025-08-20T03:53:58ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-05-0133111110.1186/s13049-025-01387-2EMCC dispatch priority for trauma patients in Norway: a retrospective cohort studyInger Marie Waal Nilsbakken0Torben Wisborg1Stephen Sollid2Elisabeth Jeppesen3Department of Research, Norwegian Air Ambulance FoundationInterprofessional rural research team – Finnmark, Faculty of Health Sciences, University of Tromsø – the Arctic University of NorwayDepartment of Research, Norwegian Air Ambulance FoundationFaculty of Health Sciences, University of StavangerAbstract Background Dispatch priority assessments in emergency medical communication centres (EMCC) play a crucial role in determining how quickly emergency medical services reach the scene after an injury. Consequently, accurate prioritization of resources is important in ensuring that patients requiring specialized care receive timely treatment to optimize their outcome. Both dispatch under-triage, where patients with severe injuries receive low priority, and dispatch over-triage, which unnecessarily allocates limited emergency resources, can impact patient outcomes and system efficiency. This study aimed to assess dispatch priority in the EMCC for a cohort of trauma patients in Norway. Methods This registry-based study included 3633 patients from the Norwegian Trauma Registry and Oslo EMCC during 2019–2020. We assessed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false negative rate (dispatch under-triage rate), false positive rate (dispatch over-triage rate), and accuracy of dispatch priority. The New Injury Severity Score (NISS) > 15 was used as a reference standard. Differences in dispatch priority assessments were analysed using descriptive statistics. Two logistic regression models were used to examine the relationship between dispatch priority and factors associated with the assessment. Results Our analysis revealed the following dispatch metrics: sensitivity (85%), specificity (11%), PPV (38%), NPV (53%), dispatch under-triage rate (15%), dispatch over-triage rate (89%), and overall accuracy (40%). Under-triaged dispatches frequently involved elderly trauma patients (53%) and patients with low-energy falls (51%). Elderly trauma patients had more than 7 times the odds of receiving inappropriately low dispatch priority compared to children and nearly twice the odds compared to adults, after accounting for factors such as injury mechanism. Similarly, female patients had 81% higher odds of receiving inappropriately low dispatch priority compared to male patients, when controlling for factors like age and injury mechanism. Among over-triaged dispatches, transport-related injuries accounted for half of the cases (50%). Conclusion This study primarily evaluated the national trauma system’s dispatch priority criteria. Our findings indicate that elderly trauma patients, those with low-energy falls and female patients were often assigned inadequate priority by current criteria, indicating a need to reassess the current criteria to better address these patients’ needs. Additionally, we found that patients involved in transport-related accidents were overrepresented among over-triaged dispatches, highlighting a potential misallocation of resources.https://doi.org/10.1186/s13049-025-01387-2TraumaPrehospital careDispatch priorityEmergency medicineTrauma registry |
| spellingShingle | Inger Marie Waal Nilsbakken Torben Wisborg Stephen Sollid Elisabeth Jeppesen EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Trauma Prehospital care Dispatch priority Emergency medicine Trauma registry |
| title | EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study |
| title_full | EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study |
| title_fullStr | EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study |
| title_full_unstemmed | EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study |
| title_short | EMCC dispatch priority for trauma patients in Norway: a retrospective cohort study |
| title_sort | emcc dispatch priority for trauma patients in norway a retrospective cohort study |
| topic | Trauma Prehospital care Dispatch priority Emergency medicine Trauma registry |
| url | https://doi.org/10.1186/s13049-025-01387-2 |
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