Selection of incidents and accurate identification of patients that require assistance from physician-staffed emergency medical services (P-EMS) remain essential. We aimed to evaluate P-EMS availability, the underlying criteria for dispatch, and the corresponding dispatch accuracy of trauma care in south-east Norway in 2015, to identify areas for improvement. Pre-hospital data from emergency medical coordination centres and P-EMS medical databases were linked with data from the Norwegian Trauma Registry (NTR). Based on a set of conditions (injury severity, interventions performed, level of consciousness, incident category), trauma incidents were defined as complex, warranting P-EMS assistance, or non-complex. Incident complexity and P-EMS involvement were the main determinants when assessing the triage accuracy. Undertriage was adjusted for P-EMS availability and response and transport times. Among 19,028 trauma incidents, P-EMS were involved in 2506 (13.2%). The range of overtriage was 74–80% and the range of undertriage was 20–32%. P-EMS readiness in the event of complex incidents ranged from 58 to 70%. The most frequent dispatch criterion was “Police/fire brigade request immediate response” recorded in 4321 (22.7%) of the incidents. Criteria from the groups “Accidents” and “Road traffic accidents” were recorded in 10,875 (57.2%) incidents, and criteria from the groups “Transport reservations” and “Unidentified problem” in 6025 (31,7%) incidents. Among 4916 patient pathways in the NTR, 681 (13.9%) could not be matched with pre-hospital data records. Both P-EMS availability and dispatch accuracy remain suboptimal in trauma care in south-east Norway. Dispatch criteria are too vague to facilitate accurate P-EMS dispatch, and pre-hospital data is inconsistent and insufficient to provide basic data for scientific research. Future dispatch criteria should focus on the care aspect of P-EMS. Better tools for both dispatch and incident handling for the emergency medical coordination centres are essential. In general, coordination, standardisation, and integration of existing data systems should enhance the quality of trauma care and increase patient safety.

中文翻译：

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挪威东南部创伤护理中由医生配备的紧急医疗服务的调度准确性：一项回顾性观察研究

选择事故并准确识别需要医生配备的紧急医疗服务 (P-EMS) 帮助的患者仍然至关重要。我们旨在评估 2015 年挪威东南部创伤护理的 P-EMS 可用性、调度的基本标准以及相应的调度准确性，以确定需要改进的领域。来自紧急医疗协调中心和 P-EMS 医疗数据库的院前数据与来自挪威创伤登记处 (NTR) 的数据相关联。基于一组条件（损伤严重程度、所进行的干预、意识水平、事件类别），创伤事件被定义为复杂的、需要 P-EMS 协助的或非复杂的。事件复杂性和 P-EMS 参与是评估分类准确性的主要决定因素。根据 P-EMS 的可用性、响应和运输时间调整了分类不足。在 19,028 起创伤事件中，P-EMS 涉及 2506 起（13.2%）。分诊过度的范围为 74-80%，分诊不足的范围为 20-32%。发生复杂事件时 P-EMS 的准备程度从 58% 到 70% 不等。最常见的调度标准是“警察/消防队要求立即响应”，记录在 4321 起 (22.7%) 的事件中。“事故”和“道路交通事故”组的标准记录在 10,875 (57.2%) 起事故中，“运输预订”和“不明问题”组的标准记录在 6025 (31.7%) 起事故中。在 NTR 的 4916 条患者路径中，681 条（13.9%）无法与院前数据记录匹配。在挪威东南部的创伤护理中，P-EMS 的可用性和调度准确性仍然欠佳。调度标准过于模糊，不利于P-EMS的准确调度，院前数据不一致，不足以为科学研究提供基础数据。未来的调度标准应侧重于 P-EMS 的护理方面。用于紧急医疗协调中心的调度和事件处理的更好工具是必不可少的。一般而言，现有数据系统的协调、标准化和集成应提高创伤护理的质量并提高患者的安全性。