The Distribution of 911 Triaged Call Incident Types within the Emergency Communication Nurse SystemTM

Introduction: This study examined the distribution of the MPDS® Chief Complaint protocols and determinant codes assigned by the EMD as eligible for nurse triage, as well as the distribution of the Chief Complaint protocols contained in the Emergency Communications Nurse SystemTM (ECNSTM) secondary nurse triage process, as determined by the emergency communications nurse (ECN). Protocol distribution was also examined by patient gender. Objective: This study characterized protocol and gender distributions to provide a better understanding of the types of patients and their associated chief complaints that benefit most from a nurse triage service in the 911 center. Methods: This study examined retrospective case data from two separate metropolitan 911 centers in the United States. The study data was a convenience sample, collected from the inception of the ECN program in each center until the start of the study. The primary outcome measures were the frequency of specific MPDS (Chief Complaint) protocols determined by the EMD for transfer to the ECN, and the frequency of specific ECNS protocols determined by the ECN during caller interaction. A secondary outcome is the gender distribution of patients for cases in the MPDS and in the ECNS. Results: Of the MPDS protocols sent (by the EMD) to be triaged through the ECNS, the Sick Person and Falls protocols had notably high frequencies. Falls, Abdominal Pain, Back Pain, and Vomiting were overall the most frequently used protocols in the ECNS itself. Female patients were users of the ECNS in significantly greater numbers than males, particularly within the Abdominal Pain and Vomiting chief complaints. Conclusion: 911 triage of patients in two urban centers yielded a variety of low acuity complaints that were handled by the ECN. In the MPDS, the five most frequently used protocols made up the vast majority (approximately 87%) of the cases transferred to the ECN, by the EMD. In the ECNS, the six most frequently used protocols made up a substantial portion (approximately 40%) of the cases triaged with those low acuity complaints.