A simple three-step dispatch rule may reduce lights and sirens responses to motor vehicle crashes
Notice bibliographique
Résumé
INTRODUCTION: Most patients involved in motor vehicle crashes (MVCs) are not seriously injured. However, dispatch protocols require an ambulance be sent with lights and sirens (L&S) to the vast majority of MVCs. L&S have been shown to reduce response times minimally. The rate of injuries among prehospital workers is nearly 15 times higher among ambulances operating with L&S than those without. OBJECTIVE: To derive a dispatch rule to reduce the need for L&S response by using MVC characteristics that could easily be described by a 9-1-1 caller. The US Centers for Disease Control Field Triage Guidelines were used as the standard for requiring L&S response; it was assumed that if a patient did not require transport to a trauma centre, he/she did not need an L&S response. METHODS: Data were extracted from prehospital patient care reports (PCRs) of patients transported by ambulance to a level I trauma centre between July 2007 and June 2008 with injuries sustained in MVCs. Patients with completed prehospital PCRs and hospital charts were included in the study. Five MVC characteristics were extracted that could easily be identified by a 9-1-1 caller. Using various permutations of these MVC characteristics, a dispatch rule was developed to determine when an ambulance should respond to an MVC without L&S. The sensitivity and specificity of this dispatch rule were calculated for both patients who met trauma centre triage criteria, and those who used trauma centre resources. RESULTS: 509 patients were included in the analysis. The following dispatch rule was developed for an ambulance response without L&S to a MVC: (1) the MVC does not occur on an interstate/highway, (2) and the MVC involves more than one car. AND (3) all patients are ambulatory. This dispatch rule was 95.9% sensitive and 33.5% specific for patients who met trauma centre criteria, and 97.7% sensitive and 32.5% specific for patients who required trauma centre resources. The study was limited by the large number of patients for whom prehospital PCRs were not available. CONCLUSIONS: A simple three-step dispatch rule for MVCs can safely reduce L&S responses by one-third, as judged by need for transport to a trauma centre or use of trauma centre resources. Prospective validation is needed.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,018 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».