The requirement concerning formal education for emergency medical dispatcher (EMD) is debated and varies, both nationally and internationally. There are few studies on the outcomes of emergency medical dispatching in relation to professional background. This study aimed to compare calls handled by an EMD with and without support by a registered nurse (RN), with respect to priority level, accuracy, and medical condition. A retrospective observational study, performed on registry data from specific regions during 2015. The ambulance personnel’s first assessment of the priority level and medical condition was used as the reference standard. Outcomes were: the proportion of calls dispatched with a priority in concordance with the ambulance personnel’s assessment; over- and undertriage; the proportion of most adverse over- and undertriage; sensitivity, specificity and predictive values for each of the ambulance priorities; proportion of calls dispatched with a medical condition in concordance with the ambulance personnel’s assessment. Proportions were reported with 95% confidence intervals. χ2-test was used for comparisons. P-levels < 0.05 were regarded as significant. A total of 25,025 calls were included (EMD n = 23,723, EMD + RN n = 1302). Analyses relating to priority and medical condition were performed on 23,503 and 21,881 calls, respectively. A dispatched priority in concordance with the ambulance personnel’s assessment were: EMD n = 11,319 (50.7%) and EMD + RN n = 481 (41.5%) (p < 0.01). The proportion of overtriage was equal for both groups: EMD n = 5904, EMD + RN n = 306, (26.4%) p = 0.25). The proportion of undertriage for each group was: EMD n = 5122 (22.9%) and EMD + RN n = 371 (32.0%) (p < 0.01). Sensitivity for the most urgent priority was 54.6% for EMD, compared to 29.6% for EMD + RN (p < 0.01), and specificity was 67.3% and 84.8% (p < 0.01) respectively. A dispatched medical condition in concordance with the ambulance personnel’s assessment were: EMD n = 13,785 (66.4%) and EMD + RN n = 697 (62.2%) (p = 0.01). A higher precision of emergency medical dispatching was not observed when the EMD was supported by an RN. How patient safety is affected by the observed divergence in dispatched priorities is an area for future research.

中文翻译：

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一项基于注册的观察性研究，比较紧急医疗调度员在有和没有注册护士支持的情况下评估的紧急呼叫

对紧急医疗调度员 (EMD) 的正规教育的要求在国内和国际上都存在争议并且各不相同。与专业背景相关的急诊医疗调度结果研究较少。本研究旨在比较 EMD 在有和没有注册护士 (RN) 支持的情况下处理的呼叫的优先级、准确性和医疗状况。一项回顾性观察研究，对 2015 年特定地区的登记数据进行。以救护人员对优先级和医疗状况的首次评估作为参考标准。结果是：根据救护人员的评估优先调度的呼叫比例；过度分类和分类不足；最不利的过度分类和分类不足的比例；灵敏度，每个救护车优先事项的特异性和预测值；与救护人员评估一致的医疗状况的呼叫比例。报告的比例具有 95% 的置信区间。χ2 检验用于比较。P 水平 < 0.05 被认为是显着的。共包括 25,025 次调用（EMD n = 23,723，EMD + RN n = 1302）。分别对 23,503 和 21,881 个电话进行了与优先级和医疗状况相关的分析。与救护人员评估一致的派遣优先级为：EMD n = 11,319 (50.7%) 和 EMD + RN n = 481 (41.5%) (p < 0.01)。两组的过度分类比例相等：EMD n = 5904，EMD + RN n = 306，(26.4%) p = 0.25)。每组的未分类比例为：EMD n = 5122 (22. 9%) 和 EMD + RN n = 371 (32.0%) (p < 0.01)。EMD 对最紧急优先事项的敏感性为 54.6%，而 EMD + RN 为 29.6% (p < 0.01)，特异性分别为 67.3% 和 84.8% (p < 0.01)。与救护人员评估一致的派遣医疗状况为：EMD n = 13,785 (66.4%) 和 EMD + RN n = 697 (62.2%) (p = 0.01)。当 EMD 由 RN 支持时，没有观察到更高的紧急医疗调度精度。观察到的分派优先级差异如何影响患者安全是未来研究的一个领域。与救护人员评估一致的派遣医疗状况为：EMD n = 13,785 (66.4%) 和 EMD + RN n = 697 (62.2%) (p = 0.01)。当 EMD 由 RN 支持时，没有观察到更高的紧急医疗调度精度。观察到的分派优先级差异如何影响患者安全是未来研究的一个领域。与救护人员评估一致的派遣医疗状况为：EMD n = 13,785 (66.4%) 和 EMD + RN n = 697 (62.2%) (p = 0.01)。当 EMD 由 RN 支持时，没有观察到更高的紧急医疗调度精度。观察到的分派优先级差异如何影响患者安全是未来研究的一个领域。