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  5. Dispatch Decisions and Emergency Medical Services Response in the Prehospital Care of Status Epilepticus

Dispatch Decisions and Emergency Medical Services Response in the Prehospital Care of Status Epilepticus

File(s)
40562000.pdf (503.63 KB)
Permanent Link(s)
https://hdl.handle.net/1813/117959
Collections
Department of Neurology
Author
McInnis, R.P.
Wood, A.J.
Shay, C.L.
Haggart, A.A.
Crowe, R.P.
Guterman, E.L.
Abstract

OBJECTIVE: Emergency medical dispatch is intended to ensure that emergency medical services (EMS) allocate appropriate resources for the treatment of patients with status epilepticus (SE). However, it is unclear whether dispatch algorithms accurately identify those patients having a seizure-related medical emergency and how dispatch algorithms influence what prehospital resources are allocated for the encounter. METHODS: We performed a cross-sectional analysis of prehospital encounters for SE using data from the 2019 ESO Data Collaborative. We included patients who were ≥18 years of age, had an EMS diagnostic impression of SE, and did not have a cardiac arrest. We examined the dispatch-determined complaint designated by the emergency medical dispatch (EMD) code, dispatch-determined level of acuity (A, B, C, D), ambulance response, and training level of the responding prehospital professional. RESULTS: Of the 18,515 patient encounters for SE with an EMD code, 8,279 (44.9%) were women, and the mean age was 40.0 years (SD 19.7). There were 13,829 (75%) encounters that received a dispatch code for seizures/convulsions and 4,686 (25%) with a dispatch code for a non-seizure-related condition. Among encounters for SE identified by dispatch as seizures/convulsions, 6,412 (46.4%) were designated high acuity, 6,626 (63.6%) were designated low acuity, and the majority received emergent ambulance responses (98.1% among those designated high acuity and 81.8% among those designated low acuity) and an Advanced Life Support-trained responder (93.7% among those designated high acuity and 92.7% among those designated low acuity). Median response times were similar for all acuity levels (9.1, 8.8, 9.1, and 8.3 minutes for A-D, respectively). CONCLUSION: Approximately one-fourth of SE cases were categorized as a non-seizure related condition at dispatch, and fewer than half received the highest acuity determinant code. Despite this, dispatch-assigned acuity did not have a strong relationship with the ambulance response or training level of the EMS responder or response time, suggesting that use of dispatch algorithms might be further optimized and highlighting a potential area to improve quality of EMS care.

Journal / Series
The western journal of emergency medicine
Volume & Issue
26(3)
Date Issued
2025-05-18
Publisher
eScholarship
Keywords
WCM Library Coordinated Deposit
•
Humans
•
Status Epilepticus/therapy/diagnosis
•
Cross-Sectional Studies
•
Female
•
Male
•
Adult
•
Emergency Medical Services/statistics & numerical data
•
Emergency Medical Dispatch/statistics & numerical data
•
Middle Aged
•
Algorithms
•
Ambulances
Related DOI
https://doi.org/10.5811/westjem.21266
Previously Published as
McInnis RP, Wood AJ, Shay CL, Haggart AA, Crowe RP, Guterman EL. Dispatch Decisions and Emergency Medical Services Response in the Prehospital Care of Status Epilepticus. The western journal of emergency medicine. 2025;26(3):549-555. doi: 10.5811/westjem.21266. PMID: 40562000.
Rights
Attribution 4.0 International
Rights URI
https://creativecommons.org/licenses/by/4.0/
Type
article

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