ReviewImproving ambulance dispatch triage to trauma: A scoping review using the framework of development and evaluation of clinical prediction rules
Section snippets
Background
The speed and accuracy of Emergency Medical Services (EMS) dispatch to the injured patient is important for optimizing patient outcomes [1,2]. Dispatch delays to motor vehicle accidents in the United States increase mortality for both urban and rural patients [3,4], and a retrospective review of prehospital trauma deaths in Victoria, Australia, identified dispatch as the most common area for systems improvement [5].
EMS dispatch often relies on humans integrating a mixture of structured and
Materials and methods
This scoping review was prepared according to the PRISMA-ScR guidelines [23]. The protocol was registered on the Open Science Framework before data extraction (https://osf.io/yprzs).
Results
The four databases and six grey literature searches yielded 2689 records. The study selection process is outlined in Fig. 1. Forty-four studies met the final inclusion criteria. Two of these investigated dispatch cancellation only and are discussed in the supplementary material, leaving 42 studies. The majority were derivation studies (21 of 42 (60%)), half of which were internal validity (12 of 21). One-quarter were either validation (10 studies) or impact (10 studies). One study was
Discussion
We performed a scoping review of ambulance dispatch triage to injured patients using a framework for development and evaluation of clinical prediction rules to summarize the types of algorithms and outcomes considered at derivation, validation and impact analysis phases. We found derivation studies to be the most common, and these rarely carried through to impact analysis. Similarly, only two studies on impact were based on previously published work. We also found few common outcomes for
Declarations of interest
None.
Acknowledgments
We would like to thank Dr. Ian Ferguson and Dr. Ilana Delroy-Buelles for their review of the original draft. Matthew Miller is supported in his PhD by an Australian Commonwealth Government Research Training Program (RTP) scholarship.
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