SHANGHAI'S CHANGES IN EMERGENCY MEDICINE INCLUDE DISPATCH

Journal Staff

International

By Journal Staff

A change in the way Shanghai, China, handles medical emergencies can only mean the medical protocols are not far behind in dispatch response.

An increasing number of nonemergency calls is behind the Shanghai medical move that replaces doctors on many of the ambulance runs with less-intensively trained medical staff and—in the Academy’s interest—gives emergency dispatchers more decision-making influence.

Part of the solution comes from Shanghai’s first-ever paramedic program that will replace doctors with less-intensively trained personnel on ambulances transporting patients home from the hospital; nurses will be on board in patient transfers between hospitals. The Shanghai Medical Emergency Center, however, will continue to staff doctors on ambulances responding to emergency calls.

In the past, no ambulance went out without a doctor, which included nonemergency trips. The system led to bottlenecks in dispatching ambulances to actual emergencies, and it was a problem exacerbated by the increasing percentage of nonemergency calls, which in 2012 was at 40%.

In addition, the Shanghai Medical Emergency Center will consolidate nine existing emergency dispatch centers into one; the dispatchers will answer all emergency calls from one location and have the discretion to decide the district responsible for sending an ambulance.

“The new measure aims to ensure that ambulances staffed with doctors are sent only to people with real medical emergencies,” said Guan Min, director, Shanghai Medical Emergency Center, in a story published in the Global Times (Sept. 3, 2013).

The Academy’s protocols are used by several centers in China, with the Wuxi Emergency Medical Services communication center becoming the first in the country to achieve Accredited Center of Excellence (ACE) status.