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Citation |
Bach A, Christensen EF. Acta Anaesthesiol. Scand. 2007; 51(6): 742-746. |
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Affiliation |
Aarhus University Hospital, Department of Anaesthesia and Intensive Care Medicine, Aarhus Traumacentre, Aarhus, Denmark. allanbach@dadlnet.dk |
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Copyright |
(Copyright © 2007, Acta Anaesthesiologica Scandinavica Foundation, Publisher John Wiley and Sons) |
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DOI |
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PMID |
17465976 |
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Abstract |
BACKGROUND: The first link in the 'chain of survival' is the activation of Emergency Medical Services (EMS). In the major part of Denmark, police officers operate the alarm 1-1-2 centre, including calls for EMS. Our aim was to study the police 1-1-2 operators' accuracy in identifying calls concerning patients with loss of consciousness as a key symptom of life-threatening conditions. 'Unconsciousness' was defined as patients with a Glasgow Coma Scale (GCS) score of < 9, scored by the on-scene anaesthesiologist from the Mobile Emergency Care Unit (MECU). METHODS: This study was an observational cohort study based on data from the Police 1-1-2 Database and the Aarhus County Pre-hospital Database containing data from MECU cases during 6 months in 2004-05. RESULTS: Two thousand, three hundred and forty-three emergency calls with MECU dispatch were identified. In 1655 cases, both 1-1-2 data and the GCS score were recorded. Two hundred and ninety-five patients were found with a GCS score of < 9 at MECU arrival, 243 of whom were reported 'unconscious' by 1-1-2, giving a sensitivity of 82%. One thousand, three hundred and sixty patients were found with a GCS score of > or = 9, 972 of whom were reported 'awake', giving a specificity of 72%. The positive predictive value (percentage of patients found with a GCS score of < 9 at MECU arrival amongst patients reported as 'unconscious') was 39%. CONCLUSIONS: The accuracy was moderate with room for improvement. The positive predictive value was low, indicating over-triage of MECU. Language: en |