What is expected of "The consultant physician at the 911 dispatch table"? Necessity of the physician for the present ambulance system.:Necessity of the Physician for the Present Ambulance System
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概要
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As a form of pre-hospital emergency care in Japan, a system termed "The consultant physician at the 911 dispatch table" has been on trial in a few cities. With this system, only one consultant physician at a time covers a relatively large area, which can be extremely beneficial in Japan where emergency medicine specialists are limited in number. However, the actual responsibilities have not been clearly defined of the consultant physician. Indeed, the question of whether the 911 switchboard operators, the ambulance team officers and/or ELSTs (emergency life-saving technicians), who are at the forefront of pre-hospital emergency care really need the assistance of consultant physicians remains largely unanswered. In the Nagoya City Ambulance Bureau, where this system has not been previously employed, we investigated 179 emergency dispatches by questionnaire to determine the level of desire for a consultant at the 911 dispatch table in such cases. As a result, the switchboard operators stated a need for a consultant in 59.9% of all cases: 56.0% of the cases in which an ELST was available in the ambulance team and 64.5% of the cases without an ELST, though this differene was not statistically significant. The ambulance team would have welcomed the assistance of a consultant in 59.2% of all cases: without an ELST the population was 57.5% and with an ELST the value was even higher at 60.6%, again this was not statistically significant, too. Reanalysis taking into account the severity of the patients' complaints, demonstrated that the operator/ambulance team needed a consultant in 90.9/100% of the CPA (cardiopulmonary arrest) subgroup, 72.7/95.5% of the severe subgroup, 65.8/66.7% of the moderate subgroup and 47.3/43.3% of the mild subgroup. There were significant differences among the severity subgroups in both operator and ambulance team groups, but no statistically significant variation between the operators and the ambulance teams.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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