Impact of a visual indicator on the noise level in an emergency medical dispatch centre - a pilot study.

BACKGROUND: Noise levels are monitored in call centres. A maximum of 52 to 55 dB(A) is recommended in order to prevent adverse events. We aimed at assessing the noise level and the impact of a visual noise indicator on the ambient noise level in a French Regional Emergency Medical Dispatch Centre (EMDC). METHODS: We conducted an observational study in the EMDC of the SAMU25 (University Hospital of Besancon). We measured the noise level using a SoundEarII® noise indicator (Dräger Medical SAS, France). The measurement took place in two phases on three consecutive days from 00:00 to 11:59 PM. At baseline, phase 1, the device recorded the average ambient noise for each minute without visual indication. Secondly, phase 2 included a sensor mounted with a light that would turn on green if noise was below 65 dB(A), orange if noise ever exceeded 65 and red if it exceeded 75 dB(A). RESULTS: In the presence of the visual noise indicator, the LAeq was significantly lower than in the absence of visual noise indicator (a mean difference of - 4.19 dB; P < 10-3). It was higher than 55 dB(A) in 84.9 and 43.9% of the time in phases 1 and 2, respectively. CONCLUSIONS: The noise levels were frequently higher than the standards, and sometimes close to recommended limits, requiring preventive measures. The noise indicator had a positive effect on the ambient noise level. This work will allow the implementation of effective prevention solutions and, based on future assessments, could improve operators' well-being and better care for patient.

[Analysis of 379 drug prescriptions at a call Center 15]. / Analyse de 379 prescriptions médicamenteuses téléphoniques dans un Centre 15.

INTRODUCTION: Prescription of medicines by telephone (PMT) in the call Center 15 is a reality, but has never been studied. OBJECTIVE: The objective was a Qualitative and quantitative study of the PMT. METHOD: A monocentric and observational study of calls for a week of the center 15 of Besançon (France) was performed. MATERIAL: Computer records and dial center 15 recordings of telephone conversations were analyzed. Variables analyzed were characteristics of callers, context of the requirement, analysis of compliance with the summary of product characteristics and mode of access to medicines. RESULTS: Among 1183 appeals studied, a PMT was performed in 379 cases (32%). New and isolated prescriptions are the most frequent. 68% of PMT correspond to optional prescriptions. The 539 drugs prescribed belong to 4 main groups: analgesics, non steroidal anti-inflammatory, anti spasmodic, anti-diarrheal. In 9 out of 10 cases these drugs are from the family pharmacy. CONCLUSION: The PMT at the center 15 is realized in one third of cases. This work helps highlight the shortcomings of the practice in terms of safety and security requirement of the proceedings against the recommendations of the French High Authority for Health.