Evidence-based optimization of urban firefighter first response to emergency medical services 9-1-1 incidents

Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors
Alan M CraigBrian Schwartz

Abstract

Many emergency medical services (EMS) systems dispatch nonparamedic firefighter first responders (FFRs) to selected EMS 9-1-1 calls, intending to deliver time-sensitive interventions such as defibrillation, cardiopulmonary resuscitation (CPR), and bag-mask ventilation prior to arrival of paramedics. Deciding when to send FFRs is complicated because critical cases are rare, paramedics often arrive before FFRs, and lights-and-siren responses by emergency vehicles are associated with the risk of en-route traffic collisions. To describe a methodology allowing EMS systems to optimize their own FFR programs using local data, and reflecting local medical oversight policy and local risk-benefit opinion. We constructed a generalized input-output model that retrospectively reviews EMS dispatch and electronic prehospital clinical records to identify a subset of Medical Priority Dispatch System (MPDS) call categories ("determinants") that maximize the opportunities for FFR interventions while minimizing unwarranted responses. Input parameters include local FFR interventions, the local FFR "first-on-scene" rate, and the locally acceptable ratio of risk to benefit. The model uses a receiver-operating characteristic (ROC) curve to identify th...Continue Reading

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Citations

Aug 26, 2014·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Lori L BolandBrian K LaCroix
Sep 14, 2013·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Evan M HodellJohn F Brown
Apr 11, 2019·Healthcare Management Forum·Emily RowlandIvy Lynn Bourgeault
Nov 5, 2015·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Thea Palsgaard MøllerFreddy Lippert

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