284:
Central Ohio 911 dispatcher adherence to national triage protocols for anaphylaxis
Saturday, March 3, 2018: 2:30 PM
S230EF (Convention Center)
Lisa M. Martorano, DO, , , , , ,
RATIONALE: Emergency Medical Services (EMS) personnel are often the first healthcare contact for patients experiencing anaphylaxis. There is a paucity of data regarding whether EMS dispatchers triage anaphylaxis appropriately. We analyzed 911 dispatch calls for allergy and anaphylaxis to determine whether EMS dispatchers accurately triaged anaphylaxis per the nationally used Advanced Medical Priority Dispatch System (AMPDS) guidelines.

METHODS: We performed a retrospective review of 146 central Ohio 911 calls over a 6 month period in 2016-2017 where the responding dispatcher’s clinical impression was allergic reaction or anaphylaxis. Using a modified Delphi approach, the calls were reviewed for dispatcher adherence to AMPDS interrogation questions and pre-arrival instructions for Allergies/Envenomation and Breathing Problems. The calls were also reviewed for symptomatology and classified as to whether the patient met criteria for anaphylaxis. We calculated frequencies for categorical measures and medians with ranges for continuous measures.

RESULTS: Of 146 calls, only 12.3% were consistent with anaphylaxis. The dispatcher asked the standardized questions about alertness, difficulty breathing, difficulty speaking and color change in 39.7%, 80.1%, 12.3% and 2.7% of calls, respectively. While 56.2% of dispatchers inquired about a history of severe allergy, only 16.4% inquired about special injections/medications and median time to dispatcher-directed use of these medications was 3 minutes.

CONCLUSIONS: Dispatchers did not follow the AMPDS guidelines to triage anaphylaxis. Future studies are needed to determine if our findings hold true in other 911 jurisdictions. There may be a need to improve the education and tools available to EMS dispatchers for triaging patients with anaphylaxis.