Dispatch Center Research Articles

Power System Operation Mode Calculation Based on Improved Deep Reinforcement Learning

Power system operation mode calculation (OMC) is the basis for unit commitment, scheduling arrangement, and stability analyses. In dispatch centers at all levels, OMC is usually realized by manually adjusting the parameters of power system components. In a new-type power system scenario, a large number of new energy sources lead to a significant increase in the complexity and uncertainty of a system structure, thus further increasing the workload and difficulty of manual adjustment. Therefore, improving efficiency and quality is of particular importance for power system OMC. This paper first considers generator power adjustment and line switching, and it then models the power flow adjustment process in OMC as a Markov decision process. Afterward, an improved deep Q-network (improved DQN) method is proposed for OMC. A state space, action space, and reward function that conform to the rules of the power system are designed. In addition, the action mapping strategy for generator power adjustment is improved to reduce the number of action adjustments and to speed up the network training process. Finally, 14 load levels under normal and N-1 fault conditions are designed. The experimental results on an IEEE-118 bus system show that the proposed method can effectively generate the operation mode under a given load level, and that it has good robustness.

The barriers and facilitators to initiation of telephone-assisted bystander cardiopulmonary resuscitation for patients experiencing out-of-hospital cardiac arrest in a private emergency dispatch centre in South Africa

BackgroundThe incidence of cardiovascular diseases, and with it out-of-hospital cardiac arrest (OHCA), is on the increase in low- to middle-income countries (LMICs), like South Africa. Interventions such as mass public cardiopulmonary resuscitation (CPR) training campaigns and public access defibrillators are expensive and out of reach for many LMICs. Telephone-assisted CPR (tCPR) is a cost-effective, scalable alternative. This study explored the barriers and facilitators to tCPR uptake in OHCA in a private South African emergency dispatch centre. MethodsThis qualitative study applied inductive dominant content analysis to emergency call recordings of OHCA cases into a private emergency dispatch centre. Calls were analysed to the latent level to identify barriers and facilitators. Cases were sampled randomly, until data saturation. ResultsSaturation occurred after the analysis of 25 recordings. A further three recordings were analysed to confirm saturation of the facilitators; yielding a final sample size of 28 calls. Overall, t-CPR was offered in 23 (82.1%) cases, but only initiated in 8 (34.8%) of these calls. Five barriers (“Poor Communication”; “Lack of Support”; “Caller Hesitance or Uncertainty;” “Emotionality”; and “Practical Barriers”) and three facilitators (“Caller Willingness”; “Support” and “CPR in Progress”) were extracted. ConclusionNumerous barriers limit the initiation of tCPR in the South African private sector EMS. It is crucial to address these barriers and leverage the facilitators in order to improve tCPR uptake. This study highlights the importance of using specific language techniques and developing tailored tCPR algorithms to overcome these barriers, which is underpinned by standardised training of call-takers.

Ambulance deployment without transport: a retrospective difference analysis for the description of emergency interventions without patient transport in Bavaria

BackgroundNot all patients who call the ambulance service are subsequently transported to hospital. In 2018, a quarter of deployments of an emergency ambulance in Bavaria were not followed by patient transport. This study describes factors that influence patient transport rates.MethodThis is a retrospective cross-sectional study based on data from all Integrated Dispatch Centres of the Free State of Bavaria in 2018. Included were ambulance deployments without emergency physician involvement, which were subdivided into ambulance deployments without transport and ambulance deployments with transport. The proportion of transported patients were determined for the primary reasons for deployment and for the different community types. On-scene time was compared for calls with and without patient transport. Differences were tested for statistical significance using Chi2 tests and the odds ratio was calculated to determine differences between groups.ResultsOf 510,145 deployments, 147,621 (28.9%) could be classified as ambulance deployments without transport and 362,524 (71.1%) as ambulance deployments with transport.The lowest proportion of patients transported was found for activations where the fire brigade was involved (“fire alarm system” 0.6%, “fire with emergency medical services” 5.4%) and “personal emergency response system active alarm” (18.6%). The highest transport rates were observed for emergencies involving “childbirth/delivery” (96.9%) and “trauma” (83.2%). A lower proportion of patients is transported in large cities as compared to smaller cities or rural communities; in large cities, the odds ratio for emergencies without transport is 2.02 [95% confidence interval 1.98–2.06] referenced to rural communites. The median on-scene time for emergencies without transport was 20.8 min (n = 141,052) as compared to 16.5 min for emergencies with transport (n = 362,524). The shortest on-scene times for emergencies without transport were identified for activations related to “fire alarm system” (9.0 min) and “personal emergency response system active alarm” (10.6 min).ConclusionThis study indicates that the proportion of patients transported depends on the reason for deployment and whether the emergency location is urban or rural. Particularly low transport rates are found if an ambulance was dispatched in connection with a fire department operation or a personal emergency medical alert button was activated. The on-scene-time of the rescue vehicle is increased for deployments without transport. The study could not provide a rationale for this and further research is needed.Trial registration This paper is part of the study “Rettungswageneinsatz ohne Transport” [“Ambulance deployment without transport”] (RoT), which was registered in the German Register of Clinical Studies under the number DRKS00017758.

Dispatcher Stroke/TIA Recognition in Emergency Medical Call Center and Out-of-Hours Service Calls in Copenhagen, Denmark.

Recognition of stroke/TIA symptoms by emergency medical services (EMS) is instrumental in providing timely recanalization treatments. We assessed the recognition of stroke/TIA by EMS via the emergency medical call center (EMCC) dispatchers and out-of-hours health service (OOHS) dispatchers. In a registry study, based on 2015-2020 data from the Copenhagen EMS, we calculated sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) of dispatcher suspicion of stroke or transient ischemic attack (TIA) and compared against discharge diagnosis. We included 462,029 contacts to EMCC and 2,573,865 contacts to OOHS. In total, 19,798 contacts had a stroke or TIA diagnosis at hospital discharge. Sensitivity was 0.64 for EMCC dispatchers and 0.25 for OOHS. PPV was 0.28 for EMCC and 0.22 for OOHS; specificity was 0.96 for EMCC and >0.99 for OOHS, and NPV was 0.99 for EMCC and >0.99 for OOHS. Sensitivity improved over the period of the study from 0.62 to 0.68 for EMCC and from 0.20 to 0.25 for OOHS. PPV did not change over the period for EMCC and decreased from 0.26 to 0.19 for OOHS. Both EMCC and OOHS more frequently overlooked stroke in women, in patients calling more than 3 hours after symptom onset, and for more severe strokes. For OHHS, advanced age correlated with lower recognition. As the first study reporting on OOHS setting dispatcher stroke/TIA recognition, we find a need for the improvement of stroke/TIA recognition both in EMCC and in OOHS. Solutions may include specific training of dispatchers, public awareness campaigns, and new technological solutions.

Dynamic ambulance relocation: a scoping review

ObjectivesDynamic ambulance relocation means that the operators at a dispatch centre place an ambulance in a temporary location, with the goal of optimising coverage and response times in future medical...

Relaxation and strain among emergency medical service personnel and emergency control center dispatchers during the first two waves of the SARS-CoV-2 pandemic.

Workloads of emergency medical service personnel (EMP) and emergency control center dispatchers (CCDs) were manifold. The SARS-CoV-2 pandemic presented new challenges for the prehospital emergency medical service. The purpose of this study was to compare the status of stress/strain and recovery of Recovery-Stress Questionnaire among EMP and CCDs in Germany during the first 2 waves of the SARS-CoV-2 pandemic both between occupational groups and over time. A total of 2426 emergency medical service personnel and control center dispatchers were questioned with the Recovery-Stress Questionnaire based on Kallus. The results from the first 2 waves of the pandemic (June-August 2020 and January-February 2021) were compared. During the first and second wave of SARS-CoV-2 pandemic, the subjectively perceived stress of emergency medical service personnel and control center dispatchers increased, but recovery decreased. The CCDs showed more unfavorable values compared to EMP. Health promotion interventions are necessary to counteract possible career changes or mental or other diseases due to insufficient management. Med Pr Work Health Saf. 2023;74(5):353-62.

History of creation and development of emergency medical care in City of Moscow

The article is devoted to the history of the creation and development of emergency medical care for the population of Moscow. The stages of the activity of the home care centers, the night emergency room at the Ambulance Station and their subsequent organization in the district emergency centers are considered. The main regulatory and legal documentation is indicated, in the development of which the heads of the Station n. a. A. S. Puchkov and A. M. Nechaev took part. The work on the creation of a system of emergency and emergency medical care for adults and children in Moscow, the rules of action of the doctor of the emergency room upon receipt of appeals is shown. The article describes the search for effective ways to solve organizational and material problems in the field of emergency and emergency medical care at different stages of the development of the emergency service. The role of the Moscow Ambulance and Emergency Medical Care Station in the development and implementation of organizational and methodological measures to improve the work of emergency departments in the capital is shown. A description of a major project is given, the purpose of which was the full integration of emergency medical care for adults and children into the structure of the Ambulance and emergency Medical Care Station in Moscow at the present stage, the organization of a Single city dispatch center for emergency and emergency medical care with the formation of a single information space, the previous preparatory work for receiving calls on a single federal number 103 on the base of the Station. During its history, the Moscow emergency medical Service has passed a difficult path. Thanks to the efforts made, the service is now an integral part of the Ambulance n. a. A. S. Puchkov and Emergency Medical Care Station in Moscow.

Telephone Assessment of Suicidal Risk at Prehospital Emergency Medical Services: A Direct Comparison with Face-to-Face Evaluation at Psychiatric Emergency Service

Objective Assessment of suicidal risk is one of the most challenging tasks faced by health professionals, notably in emergency care. We compared telephone suicide risk assessment at prehospital Emergency Medical Services Dispatch Center (EMS-DC), with subsequent face-to-face evaluation at Psychiatric Emergency Service (PES), using French national Risk-Urgency-Danger standards (RUD). Method Data were collected for all suicidal adult patients (N = 80) who were addressed by EMS-DC to PES between December 2018 and August 2019 and benefited from RUD assessment at both services. Suicidal risk was given a score of 1, 2, 3 or 4, in order of severity. Results Mean of the differences between the RUD score at EMS-DC and PES was −0.825 (SD = 1.19), and was found to be significant (p < 0.01). The average time between RUD assessments was 420 min (SD = 448) and was negatively correlated with the difference in the RUD score (r = −0.295, p = 0.008). Associated suicide attempt increased the odds of a decrease in the RUD score (OR = 2.989; 95% CI = 1.141–8.069; p < 0.05). Conclusions Telephone evaluation of suicidal risk using RUD at EMS-DC yielded moderately higher scores than those obtained by a subsequent face-to face evaluation at PES, with this difference partially explained by the time between assessments, and by clinical and contextual factors.

Tactical leaders’ and collaborative organizations’ non-technical skills during major road tunnel incidents – An iterative focus group study

IntroductionLeadership during major incidents has been described as challenging and dependent on the non-technical skills of leaders. The complex tunnel environment contributes to an even more challenging incident response. Hence, this study aims to identify elements of non-technical skills when leading collaborative road-tunnel incident responses. MethodsThe study was conducted using four focus group discussions with tactical leaders from the rescue services, emergency medical services, police, and collaborative organizations from the emergency dispatch center and road-traffic control center. The data was analyzed using a non-technical skills taxonomy. ResultsTwelve non-technical skill elements emerged. Abilities to gather, sort, and proactively share relevant information and dispatch the correct resources were described. Additionally, abilities to prioritize actions and cooperate to establish a shared operational picture were found. Abilities to adjust leadership to the tunnel environment and conditions and assess the severity of the incident to make decisions were also described. ConclusionWhen managing a road-tunnel incident response, tactical leaders utilizes a range of non-technical skills. The elements of these skills were found to be specific both to the tunnel environment and the collaborative nature of the response. Further studies into and development of these skills are needed to facilitate a timely response and minimize potential risks to personnel or evacuees in future tunnel incident responses.

IMPROVEMENT OF TECHNICAL MEASURES FOR PROCEDURES IN ACCIDENTS ON GAS SYSTEM

Due to properties as flammability, explosiveness, suffocation (decreased oxygen content), toxicity (incomplete combustion), large lengths of gas pipelines, risk of leakage, etc., natural gas is media that requires special care during transport and use. There are many examples in the world where unprofessional and negligent use of gas led to unimaginable and tragic consequences with human casualties and huge material damages. This paper analyzes management of accidental situations at the Sarajevo Canton gas system. Problematic aspects of management will be presented through two case studies instead of presenting idealized models that integrate all structures responsible for dealing with such accidental situations. The methodological approach in this paper is presented through selection of accidents on gas network that had a significant impact and required a coordinated response from the competent services. The goal is to consider possibilities of improving technical measures by installing valves with remote control, which would raise safety to a higher level. With this step forward in technical terms, it would be possible to close the valve on gas system in the shortest period of time by controlling it from the dispatch center, which would stop the uncontrolled gas release. The paper will suggest locations where it would be optimal to install valves with remote control, in order to close the necessary section, and at the same time, the least number of consumers would have a gas supply interruption. Key words: gas system, accident, technical measures

Social Media for Community Organizing: The Fight to Save Oconomowoc Dispatch

Using theories about community organizing and civic engagement, this study examines a small Wisconsin community’s efforts to save its local 911 dispatch center from being dismantled. It is a qualitative project that draws on autoethnography and interpretive content analysis to show that community organizing across multiple spheres of engagement (e.g., online and face-to-face) helps people recognize their ability to impact local politics and enact tangible change in their community. Our case study of the Save Oconomowoc Dispatch campaign suggests that social media tools are an important element of community organizing and that online citizen-led campaigns can help residents feel empowered and better prepared to act in offline settings. Most importantly, we show that a push campaign focused on disseminating information, such as the use of Facebook posts that do not feature comments, can be sufficient in helping residents recognize the importance of local services and take real-world action. This finding suggests that extensive online deliberations may not always be necessary for effective community organizing and that community leaders’ strategic use of one-way interactions on social media are effective ways of engaging residents in local politics and government.

A jolt to the system: Quantifying disaster impact and return to routine using citizen-generated calls for service.

This study compares the effect of two different types of incidents on the number of citizen-generated 9-1-1 dispatch center calls and if changes in the call numbers represent a measurable break in the expected rhythm of 9-1-1 calls. Using time series analysis, changes in the normal rhythm of calls for service (CFS) demonstrate that CFS is a good indicator of a disaster event. CFS data may potentially illustrate one aspect of measuring the degree of disaster for an event. This study establishes the value of applying time series analysis to secondary data within the framework of social routine to determine the magnitude disaster impact (or jolt) to a system. The same methodology may also be applied to examine the process of reestablishing system routine or rhythms indicating system recovery as defined as restabilization.

A hybrid electric vehicle load classification and forecasting approach based on GBDT algorithm and temporal convolutional network

Due to the participation of large-scale electric vehicles (EVs) in Vehicle-to-Grid (V2G) services, V2G dispatch centers need to predict the charging and discharging (C&D) loads of electric vehicles in a short time period. This study proposes a novel machine learning based approach for EV load forecasting in power supply systems facing high resource uncertainty. This method takes advantage of both Gradient Boosting Decision Tree (GBDT) algorithm and Time Convolutional Network (TCN) model. This study considers the service decisions of EV users and uses the GBDT algorithm to classify the EV discharge load dataset, with 92% accuracy. Also, the TCN model is used to capture local temporal features and predict the future C&D loads. In comparison with other baseline models, e.g. CNN-BILSTM, LSTM, PSO-BP, the stability of the TCN model is superior in real data charging load forecasting, and it is shown that the TCN model has the smallest error. The feasibility of the proposed GBDT-TCN hybrid model is verified by numerical cases,and achieves the RMSE of discharging forecasting less than 6.23%.

Recognition of visual symptoms in stroke: a challenge to patients, bystanders, and Emergency Medical Services

BackgroundIdentification of visual symptoms as a sign of acute stroke can be challenging for both first line healthcare professionals and lay persons. Failed recognition of visual symptoms by medical dispatchers at the Emergency Medical Dispatch Center (EMDC-112) or personnel at the Out-of-Hours Health Service (OOHS) may delay stroke revascularization. We aimed to identify correct system response to visual symptoms in emergency calls.MethodsPhone calls from patient or bystander to the EMDC-112 or OOHS, which included visual symptoms on patients later verified with stroke/Transient ischemic attack (TIA) diagnosis, were analyzed. Data were stratified according to hospitalization within and after 4.5 h from symptom onset. Descriptive and multiple logistic regression analysis were performed.ResultsOf 517 calls identified, 290 calls fulfilled inclusion criteria. Only 30% of the patients received correct visitation by the medical dispatchers and referral to the hospital by a high-priority ambulance. Correct visitation was associated with early contact (adjusted OR: 2.37, 95% CI: 1.11, 5.03), contact to the EMDC-112 (adjusted OR: 3.18, 95% CI: 1.80, 5.62), and when the medical dispatcher asked additional questions on typical stroke symptoms (adjusted OR: 6.36, 95% CI: 3.01, 13.43). No specific visual symptom was associated with stroke recognition and fast hospitalization.ConclusionsFirst line healthcare professionals had significant problems in identifying visual symptoms as a sign of acute stroke and eliciting correct response. This highlights an urgent need to improve knowledge of visual symptoms in acute stroke and emphasize correct response to stroke symptoms in general.

Comparison of outcomes of out-of-hospital cardiac arrest patients: Emergency calls placed from mobile phones vs. landline phones

BackgroundUntil recently, calls to the emergency medical service (EMS) from landline phones, which display the caller’s exact location at the dispatch center, had been common. Since the use of mobile phones has become widespread, many emergency calls are now made from mobile phones. Differences in outcomes of out-of-hospital cardiac arrest (OHCA) patients for whom EMS was called from mobile versus landline phones has not yet been fully elucidated. MethodsWe performed a retrospective, population-based analysis in Kobe, Japan to examine whether EMS calls from mobiles improved the prognosis of OHCA patients over EMS calls placed from landlines. The primary outcome was favorable neurological outcome, defined as Cerebral Performance Category (CPC) scores of 1 or 2 at discharge. Secondary outcomes were survival at one-month, survival at discharge, and time durations between call and EMS activities. ResultsOf 4,231 OHCA cases, 2,194 cases (706 landline cases vs. 1,488 mobile cases) were included in this study. The percentages of favorable neurological outcomes were 0.7% (5/706) in the landline group and 3.8% (56/1,488) in the mobile group. Adjusted multivariable logistic regression revealed that favorable neurological outcomes (odds ratio [OR] 3.03, 95% confidence interval [CI] 1.12–8.17, p = 0.03) were better in the mobile group, while one-month survival (OR 1.30, 95% CI 0.80–2.14, p = 0.29) was not significantly different. Bystander CPR was more frequently administered in the mobile group (landlines 61.3% vs. mobiles 68.4%, p < 0.01). Time durations between call to EMS dispatch (184.5 [IQR 157–220 s] vs. 205 [IQR 174–248 s], p < 0.01) and EMS arrival (476.5 [IQR 377–599 s] vs. 491 [IQR 407.5–611.5 s], p < 0.01) were shorter in the landline group. ConclusionsAlthough the landline caller location display system seems effective for shorter times between EMS call and EMS arrival, mobile phone use was associated with better neurological outcomes.

Construction and application of knowledge graph for grid dispatch fault handling based on pre-trained model

With the construction of new power systems, the power grid has become extremely large, with an increasing proportion of new energy and AC/DC hybrid connections. The dynamic characteristics and fault patterns of the power grid are complex; additionally, power grid control is difficult, operation risks are high, and the task of fault handling is arduous. Traditional power-grid fault handling relies primarily on human experience. The difference in and lack of knowledge reserve of control personnel restrict the accuracy and timeliness of fault handling. Therefore, this mode of operation is no longer suitable for the requirements of new systems. Based on the multi-source heterogeneous data of power grid dispatch, this paper proposes a joint entity–relationship extraction method for power-grid dispatch fault processing based on a pre-trained model, constructs a knowledge graph of power-grid dispatch fault processing and designs, and develops a fault-processing auxiliary decision-making system based on the knowledge graph. It was applied to study a provincial dispatch control center, and it effectively improved the accident processing ability and intelligent level of accident management and control of the power grid.

Role of hydro generation in Indian power grid to challenge the uncommon load patterns during crisis

Recently, the Indian Prime Minister Appeals to switch off the Light by people during the corona outbreak for 9 min. It also provides a significant challenge to the Indian power grid. A small malfunction of the power system may lead to a huge disaster that may worsen the daily activity of the 100 million people along with the pandemic. This review work discusses the actions of Indian power grid operation during the challenge when all the domestic Light loads are switched off for 9 min from 21:00 Hours. POSOCO (Power system Operation Corporation) of India handled the difficulty using effective actions and logged the total reduction in all India demands of about 31,089 MW (31 GW) during the event. Before the event, Indian power demand started dropping from 20:45 Hours and reaches 85,799 MW at 21:10 Hours. Subsequently, after the event, the demand begins inclined and settled around 114400 MW at 22:10 Hours. During this complete process, the grid frequency remained between 50.26 Hz and 49.70 Hz. On the other hand, the preliminary mock exercise was conducted by POSOCO before the day of the actual event and reported the expected load reduction of 15085 MW. It was anticipated by summation of SLDCs (State Load Dispatch Centers) which was half value with reported load reduction during the actual event and shows higher variance. This article also interpreted the reports of POSOCO and estimated that the actual Load reduction of this event was about 27452 MW taking place for 15 min. From the discussions, it is observed that the hydro generation schedule have the potential to minimize the havoc of the power system during steep increase and reduction of load demand during unexpected natural or artificial calamities.

Pre-Hospital Emergency Medical Services Utilization Amid COVID-19 in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany.

The COVID-19 pandemic affected the utilization of health care services and posed organizational challenges. While many previous studies focused on the misuse of pre-hospital EMS for low-urgency health problems, the pandemic has put more emphasis on the avoidance of medically necessary calls. To compare the utilization of pre-hospital emergency medical services before and after specific pandemic periods. This was a retrospective, descriptive analysis of routine data from 26 dispatch centers in Bavaria, Germany. We investigated the number of emergencies per 100,000 population, as well as the relative change in the emergency rates and transport rates in 2020, compared to the two previous years. Boxplots showed the distributions across the Bavarian districts per calendar week. The mean rates and standard deviations as well as the relative changes were presented for the specific periods. A paired samples t-test was used to compare the rates. Compared to the average of the two previous years, the emergency rates in 2020 were lower in 35 out of 52 calendar weeks. The strongest reductions were observed during the first wave, where the average emergency rate declined by 12.9% (SD 6.8, p < 0.001). There was no statistically significant difference in the overall emergency rate during the summer holidays. Lower transport rates were observed throughout the year, especially during the first wave. Utilization of pre-hospital emergency medical services decreased in 2020, especially during the periods with strict measures. This could be due to the lower morbidity from the behavioral changes during the pandemic, but also to the avoidance of medical services for both less urgent and severe conditions. While a reduction in unnecessary care would be beneficial, patients must be encouraged to seek necessary urgent care, even during a pandemic.

Swedish emergency medical dispatch centres’ ability to answer emergency medical calls and dispatch an ambulance in response to out-of-hospital cardiac arrest calls in accordance with the American Heart Association performance goals: An observational study

AimTo investigate the ability of Swedish Emergency Medical Dispatch Centres (EMDCs) to answer medical emergency calls and dispatch an ambulance for out-of-hospital cardiac arrest (OHCA) in accordance with the American Heart Association (AHA) performance goals in a 1-step (call connected directly to the EMDC) and a 2-step (call transferred to regional EMDC) procedure over 10 years, and to assess whether delays may be associated with 30-day survival. MethodObservational data from the Swedish Registry for Cardiopulmonary Resuscitation and EMDC. ResultsA total of 9,174,940 medical calls were answered (1-step). The median answer delay was 7.3 s (interquartile range [IQR], 3.6–14.5 s). Furthermore, 594,008 calls (6.1%) were transferred in a 2-step procedure, with a median answer delay of 39 s (IQR, 30–53 s). A total of 45,367 cases (0.5%, 1-step) were registered as OHCA, with a median answer delay of 7.2 s (IQR, 3.6–14.1 s) (AHA high-performance goal, 10 s). For 1-step procedure, no difference in 30-day survival was found regarding answer delay. For OHCA (1-step), an ambulance was dispatched after a median of 111.9 s (IQR, 81.7–159.9 s). Thirty-day survival was 10.8% (n = 664) when an ambulance was dispatched within 70 s (AHA high-performance) versus 9.3% (n = 2174) > 100 s (AHA acceptable) (p = 0.0013). Outcome data in the 2-step procedure was unobtainable. ConclusionThe majority of calls were answered within the AHA performance goals. When an ambulance was dispatched within the AHA high-performance standard in response to OHCA calls, survival was higher compared with calls when dispatch was delayed.

Associations between emergency call stroke triage and pre-hospital delay, primary hospital admission, and acute reperfusion treatment among early comers with acute ischemic stroke

To investigate the association between the Emergency Medical Service dispatcher’s initial stroke triage and prehospital stroke management, primary admission to hospitals offering revascularization treatment, prehospital time delay, and rate of acute revascularization. In an observational cohort study, patients with acute ischemic stroke (AIS) in Denmark (2017–2018) were included if the emergency call to the Emergency Medical Dispatch Center (EMDC) was made within three hours after symptom onset. Among 3546 included AIS patients, the EMS dispatcher identified 74.6% (95% confidence interval (CI) 73.1–76.0) correctly as stroke. EMS dispatcher stroke recognition was associated with a higher rate of primary admission to a hospital offering revascularization treatment (85.8 versus 74.5%); producing an adjusted risk difference (RD) of 11.1% (95% CI 7.8; 14.3) and a higher rate of revascularization treatment (49.6 versus 41.6%) with an adjusted RD of 8.4% (95% CI 4.6; 12.2). We adjusted for sex, age, previous stroke or transient ischemic attack, and stroke severity. EMDC stroke recognition was associated with shorter prehospital delay. For all AIS patients, the adjusted difference was − 33.2 min (95% CI − 44.4; − 22.0). Among patients receiving acute revascularization treatment (n = 1687), the adjusted difference was -12.6 min (95% CI − 18.9; − 6.3). Stroke recognition by the EMS dispatcher was associated with a higher probability of primary admission to a hospital offering acute stroke treatment, and subsequently with a higher rate of acute revascularization treatment, and with an overall reduction in prehospital delay.