Dispatch of Emergency Call Using Video Streaming Compared With Traditional Telephone Communication

In the Emergency Medical Dispatch Center, all EMS dispatchers were divided into one of two clusters with 11 EMS dispatchers in each cluster. Because of few clusters, a matched-pair (MP) design was used based on the average proportion of the dispatched level of urgency (highest level of urgency used as primary matching criteria), years of employment and the average duration of emergency calls in a 3-months period (1st of January 2022 - 31st of March 2022) before the implementation of video streaming. Newly employed personnel where matching was not possible were randomly assigned to one of the two clusters. Prior to the study period, video streaming was gradually implemented in the intervention group during a 6-months period (1st of July 2022 - 31st of December 2022).

Using a cluster randomized setup, the aim was to investigate differences in the management of emergency calls (dispatches) when emergency medical service (EMS) dispatchers use video streaming compared with telephone-only (audio-only) communication. All emergency calls will be randomly distributed between the two clusters.

In Denmark, all emergency medical calls are answered by a nurse- or paramedic trained in dispatching emergencies. The EMS dispatcher determines the level of urgency and the type and number of resources to be allocated (e.g., ambulance, physician-manned vehicle and/or physician-manned helicopter (HEMS). The decision-making process is supported by a standardized national criteria-based dispatch tool called Danish Index for Emergency Care (DI). DI is a tool that classifies the patient's main complaint into different symptom groups (chapters) to determine the level of urgency required and which resources to allocate.

As standard, emergency calls are based on telephone-only (audio-only) communication, which might limit the understanding of a complex clinical presentation.

Previous studies suggest that a visualized clinical presentation could aid the EMS dispatchers in their decision-making and dispatch.

The decision on implementing video streaming has been made by the management board of the Prehospital Emergency Medical Services, Central Denmark Region, Denmark. It has been decided to implement video streaming gradually to allow for this cluster randomized study. Because video streaming is a deemed part of the standard operating procedure (SOP), ethical approval from our local ethical committee is waived. After the study period, video streaming will be implemented in the current control group as the decision to use video streaming as SOP has already been decided.

Eligibility Criteria:
Inclusion Criteria:

* Emergency call to the EMS dispatcher in the EMDC
* EMS dispatcher employed in the total study period
* EMS dispatchers with a completed training period (6 weeks total) at the start of the study period

Exclusion Criteria:

* Emergency calls directed to an EMDC physician or technical logistical personnel not using the criteria-based dispatch tool
* non-emergency calls (health care provider requested prehospital transports)
* EMS dispatcher not employed in the total study period
* EMS dispatchers without a completed training period (6 weeks total) at the start of the study period