RT Journal Article
SR Electronic
T1 Accuracy of emergency medical service telephone triage of need for an ambulance response in suspected COVID-19: an observational cohort study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e058628
DO 10.1136/bmjopen-2021-058628
VO 12
IS 5
A1 Carl Marincowitz
A1 Tony Stone
A1 Madina Hasan
A1 Richard Campbell
A1 Peter A Bath
A1 Janette Turner
A1 Richard Pilbery
A1 Benjamin David Thomas
A1 Laura Sutton
A1 Fiona Bell
A1 Katie Biggs
A1 Frank Hopfgartner
A1 Suvodeep Mazumdar
A1 Jennifer Petrie
A1 Steve Goodacre
YR 2022
UL http://bmjopen.bmj.com/content/12/5/e058628.abstract
AB Objective To assess accuracy of emergency medical service (EMS) telephone triage in identifying patients who need an EMS response and identify factors which affect triage accuracy.Design Observational cohort study.Setting Emergency telephone triage provided by Yorkshire Ambulance Service (YAS) National Health Service (NHS) Trust.Participants 12 653 adults who contacted EMS telephone triage services provided by YAS between 2 April 2020 and 29 June 2020 assessed by COVID-19 telephone triage pathways were included.Outcome Accuracy of call handler decision to dispatch an ambulance was assessed in terms of death or need for organ support at 30 days from first contact with the telephone triage service.Results Callers contacting EMS dispatch services had an 11.1% (1405/12 653) risk of death or needing organ support. In total, 2000/12 653 (16%) of callers did not receive an emergency response and they had a 70/2000 (3.5%) risk of death or organ support. Ambulances were dispatched to 4230 callers (33.4%) who were not conveyed to hospital and did not deteriorate. Multivariable modelling found variables of older age (1 year increase, OR: 1.05, 95% CI: 1.04 to 1.05) and presence of pre-existing respiratory disease (OR: 1.35, 95% CI: 1.13 to 1.60) to be predictors of false positive triage.Conclusion Telephone triage can reduce ambulance responses but, with low specificity. A small but significant proportion of patients who do not receive an initial emergency response deteriorated. Research to improve accuracy of EMS telephone triage is needed and, due to limitations of routinely collected data, this is likely to require prospective data collection.Data may be obtained from a third party and are not publicly available. The data used for this study are subject to data sharing agreements with NHS Digital and Yorkshire Ambulance Service which prohibits further sharing of individual level data by the research team. The data sets used are obtainable from these organisations subject to necessary authorisations and approvals.