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2011, vol. 17, br. 3-4, str. 136-140
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Razlika u vremenskoj raspodeli poziva prvog i drugog reda hitnosti, kod bola u grudima, u Gradskom zavodu za hitnu medicinsku pomoć u Beogradu
Difference in time on hold between calls of first and second level of triage emergency, for patients with chest pain at Emergency medical service in Belgrade
Sažetak
U radu Hitne pomoći (HP) u Beogradu na 1.763 intervencije s bolom u grudima u tri meseca septembar-novembar 2010. godine, izvršena je analiza zadržavanja kod dispečera poziva prvog i drugog reda hitnosti, pre davanja ekipama na terenu. Procena hitnosti na telefonskoj centrali Hitne pomoći u Beogradu se obavlja tako što operateri u pozivnom centru (Call centar) koriste uputstvo - protokol INDEX za prijem poziva postavljajući odgovarajuća pitanja. Iz odgovora na ta pitanja zaključuje se da li na takav poziv treba da se uputi lekarska ekipa i da li takav poziv treba da se označi kao poziv prvog ili drugog reda hitnosti. Dispečer dodeljuje pozive na izvršenje slobodnoj ekipi, za koju smatra da će najbrže stići do pozivaoca, uzimajući u obzir red hitnosti, udaljenost, uslove saobraćaja, raspored ekipa na terenu. Ekipu na terenu u HP Beograd čine lekar, medicinski tehničar i vozač obučen za pomoć u zbrinjavanju hitnih stanja. Pozivi označeni kao prvi red hitnosti ili crveni pozivi u proseku čekaju 1,57 min. Najkraće čekanje je tri sek. a najduže skoro 27 min. U prvih pet minuta po prijemu, ekipama se daje na izvršenje 95% ovih poziva. Pozivi drugog reda hitnosti čekaju u proseku 8,10 min, minimum čekanja je 4 sek. a najduže 35 min. U prvih 5 minuta po prijemu, ekipama se daje na izvršenje 50% ovih poziva Kada nema opterećenja pozivima, svi pozivi se daju ekipama na izvršenje praktično odmah, a u slučajevima kada opterećenje postoji, ili u kritičnim trenucima, kao, na primer, smena ekipa dva puta dnevno, saobraćajni špicevi ili druga zakrčenja saobraćaja u gradu, koja se povremeno dešavaju i kada je usporen rad ekipa - hitni pozivi imaju prioritet, tj. daju se odmah a žuti pozivi čekaju na red dok se ne završi intervencija po svim crvenim pozivima. Testiranjem t- testom srednjih vrednosti čekanja ove dve grupe poziva, dobijamo da je t>2,25; p<0,01. Dobijena je statistički visoko značajna razlika, tj. pozivi prvog reda hitnosti statistički visoko značajno kraće vreme stoje kod dispečera pre davanja ekipama na izvršenje.
Abstract
In 1763 interventions with chest pain of Emergency medical service (EMS), during three months (September to November, 2010), analysis has been made regarding difference in holding time at dispatcher between first and second degree emergency calls, before they were given to teams on field. Emergency evaluation on the telephone central of EMS is done in the way that operators on telephone use direction-protocol-index in order to ask suitable questions to the callers. Based on the answers to those questions operators decide weather to send medical team or not, and how should they mark emergency level for the call (first or second level). Dispatcher assigns calls on execution to the free team which, in his opinion, can get there fastest, considering degree of emergency, distance, traffic conditions, and team's location. Team on the filed in EMS Belgrade consists of doctor, medical technician and the driver who is trained for help in taking care of emergency conditions. Calls marked as first emergency level, or red calls, wait in average 1 min 57 sec. Shortest wait is 3 sec and longest almost 27 min. In first five minutes after receiving, teams are assigned for 95% of these calls. When load of calls is low, then all of the calls are given to teams practically immediately, and in cases when there is considerable load of calls, or in critical moments that happen occasionally (for example change of teams twice a day, traffic crowds or other traffic problems), and work of teams is made slow, red calls have priority and they are assigned right away, and yellow (second degree) wait until red calls are done. By testing average values of holding time for these two groups of calls with t test, we get that t>2 min 25 sec p>0.01. We get statistically very important difference, which means that calls of the first level, wait much shorter at the dispatcher, before assigning them to teams.
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Reference
|
|
1  
|
Deakin, C.D., Sherwood, D.M., Smith, A., Cassidy, M. (2006) Does telephone triage of emergency (999) calls using advanced medical priority dispatch (AMPDS) with Department of Health (DH) call prioritisation effectively identify patients with an acute coronary syndrome?: An audit of 42, 657. Emerg Med J., 23, str. 232-7
|
|
 
|
Feldman, M.J., Verbeek, R.P., Lyons, D.G., Chad, S.J., Craig, A.M., Schwartz, B. (2006) Comparison of the medical priority dispatch system to an out-of-hospital patient acuity score. Academic emergency medicine, 13(9): 954-60
|
|
|
Figgis, K., Slevin, O., Cunningham, B.J. (2010) Investigation of paramedics' compliance with clinical practice guidelines for the management of chest pain. Emergency medicine journal, 27(2): 151-5
|
|
|
Fischer, M., Kamp, J., Garcia-Castrillo, R.L., Robertson-Steel, I., Overton, J., Ziemann, A., Krafft, T. (2011) Comparing emergency medical service systems: A project of the European Emergency Data (EED) Project. Resuscitation, 82(3): 285-93
|
|
|
Hinchey, P., Myers, B., Zalkin, J., Lewis, R., Garner, D. (2007) Low acuity EMS dispatch criteria can reliably identify patients without high-acuity illness or injury. Prehospital emergency care, 11(1): 42-8
|
|
|
Khorram-Manesh, A., Lennquist, M.K., Hedelin, A., Kihlgren, M. (2010) Prehospital triage, discrepancy in priority-setting between emergency medical dispatch centre and ambulance crews. European Journal of Trauma and Emergency Surgery, str. 1-6
|
|
|
Løvlien, M., Schei, B., Hole, T. (2007) Prehospital delay, contributing aspects and responses to symptoms among Norwegian women and men with first time acute myocardial infarction. European journal of cardiovascular nursing, 6(4): 308-13
|
|
|
Owczuk, R., Wujtewicz, M.A., Sawicka, W., Wujtewicz, M., Szlyk-Augustyn, M., Wadrzyk, A. (2003) Analysis of causes of emergency medical service resuscitation teams being called to elderly patients. New Medicine, 6(4), str. 100-103
|
|
|
Petković, J., Gajić, V., Jestrović, N., Jovanović, B., Spasić, M., Gajić, S. (2009) Diferencijalna dijagnoza bola u grudima u radu lekara Hitne pomoći Kragujevac. ABC - časopis urgentne medicine, vol. 9, br. 1, str. 56-63
|
|
1
|
Silverman, R.A., Galea, S., Blaney, S., Freese, J., Prezant, D.J., Park, R., Pahk, R., Caron, D., Yoon, S., Epstein, J., Richmond, N.J. (2007) The 'vertical response time': Barriers to ambulance response in an urban area. Academic emergency medicine, 14(9): 772-8
|
|
2
|
Sporer, K.A., Youngblood, G.M., Rodriguez, R.M. (2007) The ability of emergency medical dispatch codes of medical complaints to predict ALS prehospital interventions. Prehospital emergency care, 11(2): 192-8
|
|
|
Vukadinović, E., Radojević, A., Kostić, M., Kocić, Z. (2010) Akutni koronarni sindrom - prepoznavanje na prijemu poziva i njegova potvrda na terenu. ABC - časopis urgentne medicine, vol. 10, br. 1, str. 14-19
|
|
2
|
Zakariassen, E., Burman, R., Hunskaar, S. (2010) The epidemiology of medical emergency contacts outside hospitals in Norway: A prospective population based study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 18(1): 9
|
|
|
|
|