All 999 calls involving major trauma operationalised as being a call judged by Helicopter Emergency Medical Services (HEMS) dispatcher and/or Critical Care Paramedic (CCP) as likely to require enhanced dispatch (either Critical Care Paramedic and/or HEMS dispatch) for Trauma Injury, Occupational Diseases, Poisoning
Conditions
Interventions
Randomisation: 999 calls during six observation weeks (42 days
84 shifts), allocated 1:1 by working shift to intervention or standard care using a computer-generated randomisation list.
Control: Standard care ambulance dispatch protocol with a 999 caller using
Critical Care Paramedic (CCP) or Air Ambulance can be escalated or de-escalated).
Sponsors
University of Surrey
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current participant inclusion criteria as of 11/08/2022: All 999 calls involving major trauma operationalised as being a call judged by Helicopter Emergency Medical Services (HEMS) dispatcher and/or Critical Care Paramedic (CCP) as likely to require enhanced dispatch (either Critical Care Paramedic and/or HEMS dispatch) for Trauma Previous participant inclusion criteria: All 999 calls involving trauma triaged as either Category 1 or 2; all calls screened by Helicopter Emergency Medical Services (HEMS) dispatcher involving trauma
Exclusion criteria
Exclusion criteria: Current participant exclusion criteria as of 11/08/2022: 1. All emergencies of a suspected medical origin 2. All trauma calls where: 2.1. Caller not at the scene 2.2. Call from a landline 2.3. Call from another emergency service: police or fire 2.4. Calls where resource (excluding community first responder) will arrive on scene before live streaming could be activated 2.5. Call ended before transfer for activation of live streaming 2.6. Calls where another incident takes priority 2.7. Calls where clinical acuity is found to be lower than threshold for entry to the study (not major trauma) Previous participant exclusion criteria: All emergencies of a suspected medical origin
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Proportion of callers with smartphones agreeing and able to activate live streaming, measured using the observational proforma completed by research paramedics prospectively (live) during trial periods. The proforma will be completed for each call (control and intervention arm) during the trial periods and it will be noted whether or not the caller was using a smartphone to call (yes/no/don’t know) and whether or not they were willing (yes/no) and able (yes/no) to activate live streaming. 2. Proportion of requests to activate live streaming resulting in footage being obtained (allowing for margin for lack of 3G/4G/5G coverage), measured using the observational proforma completed by research paramedics prospectively (live) during trial periods. The proforma will be completed for each call (control and intervention arm) during trial periods and it will be noted whether or not the footage was obtained and any issues with quality of visual/audio quality. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Speed of appropriate emergency services dispatch, measured using time-stamped data from the start of 999 calls to appropriate deployment; appropriateness based on expert consensus criteria and using data up to 3 months post-incident 2. Stand-down rate (de-escalation) measured using the observational proforma completed by research paramedics prospectively (live) during trial periods. The proforma will be completed for each call (control and intervention arm) during the trial periods. On the proforma, the research paramedics will record if and when the ambulance (A), CCP (C) and/or the air ambulance (helicopter, H) were activated or stood down, and timestamps and reasons associated with these decisions. The use (or not) of live streaming will be noted. Changes to dispatch are automatically recorded on the CAD and timestamps and so can and will be verified against this source. 3. Missed jobs (e.g. not prioritised for HEMS/CCP despatch, either due to lack of resource or inappropriate prioritisation), measured using the observational proforma completed ‘live’ (during the incident/dispatch) by the research paramedics observing each call by logging a) all requests by the first ambulance on scene for further ambulance resource/assistance from CCPs or Air Ambulance; and b) by logging requests for CCP/Air Ambulance that could not be dispatched due to lack of resource. 4. Requests for further ambulance resources from the scene, measured using the observational proforma completed by research paramedics observing each call who would log requests for further ambulance resources (Ambulance, CCP and/or Air Ambulance) from scene. This will be recorded live and can be cross-checked with the CAD. 5. Psychological harm assessed pre and post-intervention period in staff viewing the footage (and also measured in staff within a comparison EOC not using GoodSAM); and in callers from both arms 6-8 weeks post-incident, using two validated scales (the Impact of Event Scale - Revised and t | — |
Countries
England, United Kingdom
Contacts
Public ContactLucie Ollis
Outcome results
None listed