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Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey

Helen Snooks Orcid Logo, Alan Watkins Orcid Logo, Fiona Bell, Mike Brady, Andy Carson‐Stevens, Edward Duncan, Bridie Evans Orcid Logo, Louise England, Theresa Foster, John Gallanders, Imogen Gunson, Robert Harris‐Mayes, Mark Kingston Orcid Logo, Ronan Lyons Orcid Logo, Elisha Miller, Andy Newton, Alison Porter Orcid Logo, Tom Quinn, Andy Rosser, Aloysius Niroshan Siriwardena, Robert Spaight, Victoria Williams

Journal of the American College of Emergency Physicians Open, Volume: 2, Issue: 4, Start page: e12492

Swansea University Authors: Helen Snooks Orcid Logo, Alan Watkins Orcid Logo, Bridie Evans Orcid Logo, Mark Kingston Orcid Logo, Ronan Lyons Orcid Logo, Alison Porter Orcid Logo, Victoria Williams

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DOI (Published version): 10.1002/emp2.12492

Abstract

ObjectivesDuring the first wave of the COVID-19 pandemic in the United Kingdom (UK), to describe volume and pattern of calls to emergency ambulance services, proportion of calls where an ambulance was dispatched, proportion conveyed to hospital, and features of triage used.MethodsSemistructured elec...

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Published in: Journal of the American College of Emergency Physicians Open
ISSN: 2688-1152 2688-1152
Published: Wiley 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa57875
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Questionnaires and data request were emailed to chief executives and research leads followed by email and telephone reminders. The routine data were analyzed using descriptive statistics, and questionnaire data using thematic analysis.ResultsCompleted questionnaires were received from 12 services. Call volume varied widely between services, with a UK peak at week 7 at 13.1% above baseline (service range -0.5% to +31.4%). All services ended the study period with a lower call volume than at baseline (service range -3.7% to -25.5%). Suspected COVID-19 calls across the UK totaled 604,146 (13.5% of all calls), with wide variation between services (service range 3.7% to 25.7%), and in service peaks of 11.4% to 44.5%. Ambulances were dispatched to 478,638 (79.2%) of these calls (service range 59.0% to 100.0%), with 262,547 (43.5%) resulting in conveyance to hospital (service range 32.0% to 53.9%). Triage models varied between services and over time. Two primary call triage systems were in use across the UK. There were a large number of products and arrangements used for secondary triage, with services using paramedics, nurses, and doctors to support decision making in the call center and on scene. Frequent changes to triage processes took place.ConclusionsCall volumes were highly variable. Case mix and workload changed significantly as COVID-19 calls displaced other calls. Triage models and prehospital outcomes varied between services. We urgently need to understand safety and effectiveness of triage models to inform care during further waves and pandemics.</abstract><type>Journal Article</type><journal>Journal of the American College of Emergency Physicians Open</journal><volume>2</volume><journalNumber>4</journalNumber><paginationStart>e12492</paginationStart><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2688-1152</issnPrint><issnElectronic>2688-1152</issnElectronic><keywords>Pandemic, Ambulances, Triage, Prehospital Emergency Care, Covid&#x2010;19</keywords><publishedDay>2</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-08-02</publishedDate><doi>10.1002/emp2.12492</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2022-10-27T11:42:11.7985524</lastEdited><Created>2021-09-13T16:06:17.4423838</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>1</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>2</order></author><author><firstname>Fiona</firstname><surname>Bell</surname><order>3</order></author><author><firstname>Mike</firstname><surname>Brady</surname><order>4</order></author><author><firstname>Andy</firstname><surname>Carson&#x2010;Stevens</surname><order>5</order></author><author><firstname>Edward</firstname><surname>Duncan</surname><order>6</order></author><author><firstname>Bridie</firstname><surname>Evans</surname><orcid>0000-0003-0293-0888</orcid><order>7</order></author><author><firstname>Louise</firstname><surname>England</surname><order>8</order></author><author><firstname>Theresa</firstname><surname>Foster</surname><order>9</order></author><author><firstname>John</firstname><surname>Gallanders</surname><order>10</order></author><author><firstname>Imogen</firstname><surname>Gunson</surname><order>11</order></author><author><firstname>Robert</firstname><surname>Harris&#x2010;Mayes</surname><order>12</order></author><author><firstname>Mark</firstname><surname>Kingston</surname><orcid>0000-0003-2242-4210</orcid><order>13</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><orcid>0000-0001-5225-000X</orcid><order>14</order></author><author><firstname>Elisha</firstname><surname>Miller</surname><order>15</order></author><author><firstname>Andy</firstname><surname>Newton</surname><order>16</order></author><author><firstname>Alison</firstname><surname>Porter</surname><orcid>0000-0002-3408-7007</orcid><order>17</order></author><author><firstname>Tom</firstname><surname>Quinn</surname><order>18</order></author><author><firstname>Andy</firstname><surname>Rosser</surname><order>19</order></author><author><firstname>Aloysius Niroshan</firstname><surname>Siriwardena</surname><order>20</order></author><author><firstname>Robert</firstname><surname>Spaight</surname><order>21</order></author><author><firstname>Victoria</firstname><surname>Williams</surname><orcid/><order>22</order></author></authors><documents><document><filename>57875__20837__4001d3eb3379469f8b6c1a945b02a562.pdf</filename><originalFilename>57875.pdf</originalFilename><uploaded>2021-09-13T16:12:14.5150622</uploaded><type>Output</type><contentLength>379423</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2021 The Authors. 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spelling 2022-10-27T11:42:11.7985524 v2 57875 2021-09-13 Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false 3442763d6ff0467963e0792d2b5404fa 0000-0003-2242-4210 Mark Kingston Mark Kingston true false 83efcf2a9dfcf8b55586999d3d152ac6 0000-0001-5225-000X Ronan Lyons Ronan Lyons true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false e9bb438bfaaf693c0376c20c9e4529d2 Victoria Williams Victoria Williams true false 2021-09-13 MEDS ObjectivesDuring the first wave of the COVID-19 pandemic in the United Kingdom (UK), to describe volume and pattern of calls to emergency ambulance services, proportion of calls where an ambulance was dispatched, proportion conveyed to hospital, and features of triage used.MethodsSemistructured electronic survey of all UK ambulance services (n = 13) and a request for routine service data on weekly call volumes for 22 weeks (February 1–July 3, 2020). Questionnaires and data request were emailed to chief executives and research leads followed by email and telephone reminders. The routine data were analyzed using descriptive statistics, and questionnaire data using thematic analysis.ResultsCompleted questionnaires were received from 12 services. Call volume varied widely between services, with a UK peak at week 7 at 13.1% above baseline (service range -0.5% to +31.4%). All services ended the study period with a lower call volume than at baseline (service range -3.7% to -25.5%). Suspected COVID-19 calls across the UK totaled 604,146 (13.5% of all calls), with wide variation between services (service range 3.7% to 25.7%), and in service peaks of 11.4% to 44.5%. Ambulances were dispatched to 478,638 (79.2%) of these calls (service range 59.0% to 100.0%), with 262,547 (43.5%) resulting in conveyance to hospital (service range 32.0% to 53.9%). Triage models varied between services and over time. Two primary call triage systems were in use across the UK. There were a large number of products and arrangements used for secondary triage, with services using paramedics, nurses, and doctors to support decision making in the call center and on scene. Frequent changes to triage processes took place.ConclusionsCall volumes were highly variable. Case mix and workload changed significantly as COVID-19 calls displaced other calls. Triage models and prehospital outcomes varied between services. We urgently need to understand safety and effectiveness of triage models to inform care during further waves and pandemics. Journal Article Journal of the American College of Emergency Physicians Open 2 4 e12492 Wiley 2688-1152 2688-1152 Pandemic, Ambulances, Triage, Prehospital Emergency Care, Covid‐19 2 8 2021 2021-08-02 10.1002/emp2.12492 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University 2022-10-27T11:42:11.7985524 2021-09-13T16:06:17.4423838 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Helen Snooks 0000-0003-0173-8843 1 Alan Watkins 0000-0003-3804-1943 2 Fiona Bell 3 Mike Brady 4 Andy Carson‐Stevens 5 Edward Duncan 6 Bridie Evans 0000-0003-0293-0888 7 Louise England 8 Theresa Foster 9 John Gallanders 10 Imogen Gunson 11 Robert Harris‐Mayes 12 Mark Kingston 0000-0003-2242-4210 13 Ronan Lyons 0000-0001-5225-000X 14 Elisha Miller 15 Andy Newton 16 Alison Porter 0000-0002-3408-7007 17 Tom Quinn 18 Andy Rosser 19 Aloysius Niroshan Siriwardena 20 Robert Spaight 21 Victoria Williams 22 57875__20837__4001d3eb3379469f8b6c1a945b02a562.pdf 57875.pdf 2021-09-13T16:12:14.5150622 Output 379423 application/pdf Version of Record true © 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
spellingShingle Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
Helen Snooks
Alan Watkins
Bridie Evans
Mark Kingston
Ronan Lyons
Alison Porter
Victoria Williams
title_short Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
title_full Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
title_fullStr Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
title_full_unstemmed Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
title_sort Call volume, triage outcomes, and protocols during the first wave of the COVID‐19 pandemic in the United Kingdom: Results of a national survey
author_id_str_mv ab23c5e0111b88427a155a1f495861d9
81fc05c9333d9df41b041157437bcc2f
6098eddc58e31ac2f3e070cb839faa6a
3442763d6ff0467963e0792d2b5404fa
83efcf2a9dfcf8b55586999d3d152ac6
fcc861ec479a79f7fb9befb13192238b
e9bb438bfaaf693c0376c20c9e4529d2
author_id_fullname_str_mv ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
3442763d6ff0467963e0792d2b5404fa_***_Mark Kingston
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
e9bb438bfaaf693c0376c20c9e4529d2_***_Victoria Williams
author Helen Snooks
Alan Watkins
Bridie Evans
Mark Kingston
Ronan Lyons
Alison Porter
Victoria Williams
author2 Helen Snooks
Alan Watkins
Fiona Bell
Mike Brady
Andy Carson‐Stevens
Edward Duncan
Bridie Evans
Louise England
Theresa Foster
John Gallanders
Imogen Gunson
Robert Harris‐Mayes
Mark Kingston
Ronan Lyons
Elisha Miller
Andy Newton
Alison Porter
Tom Quinn
Andy Rosser
Aloysius Niroshan Siriwardena
Robert Spaight
Victoria Williams
format Journal article
container_title Journal of the American College of Emergency Physicians Open
container_volume 2
container_issue 4
container_start_page e12492
publishDate 2021
institution Swansea University
issn 2688-1152
2688-1152
doi_str_mv 10.1002/emp2.12492
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description ObjectivesDuring the first wave of the COVID-19 pandemic in the United Kingdom (UK), to describe volume and pattern of calls to emergency ambulance services, proportion of calls where an ambulance was dispatched, proportion conveyed to hospital, and features of triage used.MethodsSemistructured electronic survey of all UK ambulance services (n = 13) and a request for routine service data on weekly call volumes for 22 weeks (February 1–July 3, 2020). Questionnaires and data request were emailed to chief executives and research leads followed by email and telephone reminders. The routine data were analyzed using descriptive statistics, and questionnaire data using thematic analysis.ResultsCompleted questionnaires were received from 12 services. Call volume varied widely between services, with a UK peak at week 7 at 13.1% above baseline (service range -0.5% to +31.4%). All services ended the study period with a lower call volume than at baseline (service range -3.7% to -25.5%). Suspected COVID-19 calls across the UK totaled 604,146 (13.5% of all calls), with wide variation between services (service range 3.7% to 25.7%), and in service peaks of 11.4% to 44.5%. Ambulances were dispatched to 478,638 (79.2%) of these calls (service range 59.0% to 100.0%), with 262,547 (43.5%) resulting in conveyance to hospital (service range 32.0% to 53.9%). Triage models varied between services and over time. Two primary call triage systems were in use across the UK. There were a large number of products and arrangements used for secondary triage, with services using paramedics, nurses, and doctors to support decision making in the call center and on scene. Frequent changes to triage processes took place.ConclusionsCall volumes were highly variable. Case mix and workload changed significantly as COVID-19 calls displaced other calls. Triage models and prehospital outcomes varied between services. We urgently need to understand safety and effectiveness of triage models to inform care during further waves and pandemics.
published_date 2021-08-02T20:04:57Z
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score 11.04748

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