Study Of Consciousness Assessment Via Simulated Emergency Calls By Citizen Volunteers

DOI 13 References Open Access
  • Morimura Naoto
    Trauma and Critical Care Center, Teikyo University School of Medicine
  • Ishikawa Junya
    Critical Care and Emergency Center, Yokohama City University Medical Center
  • Kitsuta Yoichi
    Critical Care and Emergency Center, Yokohama City University Medical Center
  • Nakamura Kyota
    Critical Care and Emergency Center, Yokohama City University Medical Center
  • Anze Masaki
    Critical Care and Emergency Center, Yokohama City University Medical Center
  • Sugiyama Mitsugi
    Critical Care and Emergency Center, Yokohama City University Medical Center

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  • 緊急通報シミュレーションによる意識評価のための交信方法の検討

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Background: Emergency call triage (ECT) is a cornerstone in establishing medical regulations that ensure efficient transport for victims and the availability of out-of-hospital emergency medical teams including attending physicians. ECT itself must be recognized as a part of medical control. Quick identification of the consciousness level, pulse, and respiration is essential for adequate ECT. This report discusses a role-play study of emergency calls with citizen volunteers and analysis for risk factors in failed telephone communication to confirm patient consciousness. Method: Six physicians played emergencypatients, and 84 citizen volunteers--13 men and 71 women with an average age of 50 [95% CI: 46-53] years--were enrolled. Simulated medical dispatchers directed and assessed patients' consciousness by telecommunication. Telecommunication was evaluated as successful by monitoring voice and television simultaneously. Results: Communication (%) (successful telecommunication/all evaluated telecommunications) was 70.6% (72/102) for patient consciousness. In a consciousness-disturbance setting, callers used initial expressions without patients' complaints more frequently than in a normal setting. Communication for consciousness status was significantly lower than in a normal setting. The risk factor for failed telecommunications was the expression pattern of interrogation by medical dispatchers, which included “Please confirm to check...” Concrete orders for how to check without vagueness contributed to better successful telecommunication. Conclusion: To establish an ECT protocol in Japanese, these results showed the need for individual responses based on classification of the caller's initial expressions, and concrete and nonvague expression patterns of interrogation. Interrogation items should also be clarified.

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