When do medical operators choose to use, or not use, video in emergency calls? A case study.

BackgroundAn evaluation report for a pilot project on the use of video in medical emergency calls between the caller and medical operator indicates that video is only used in 4% of phone calls to the emergency medical communication centre (EMCC). Furthermore, the report found that in half of these cases, the use of video did not alter the assessment made by the medical operator at the EMCC.We aimed to describe the reasons for when and why medical operators choose to use or not use video in emergency calls. METHOD: The study was conducted in a Norwegian EMCC, employing a thematic analysis of notes from medical operators responding to emergency calls regarding the use of video. RESULT: Informants reported 19 cases where video was used and 46 cases where it was not used. When video was used, three main themes appeared: 'unclear situation or patient condition', 'visible problem' and 'children'. When video was not used the following themes emerged: 'cannot be executed/technical problems', 'does not follow instructions', 'perceived as unnecessary'. Video was mostly used in cases where the medical operators were uncertain about the situation or the patients' conditions. CONCLUSION: The results indicate that medical operators were selective in choosing when to use video. In cases where operators employed video, it provided a better understanding of the situation, potentially enhancing the basis for decision-making.

Gamification of the National Institutes of Health Stroke Scale (NIHSS) for simulation training-a feasibility study.

BACKGROUND: Training prehospital personnel in identifying patients with acute stroke is key to providing rapid treatment. This study aimed to investigate whether game-based digital simulation training is a feasible alternative to standard in-person simulation training. METHODS: Second-year paramedic bachelor students at Oslo Metropolitan University in Norway were invited to participate in a study to compare game-based digital simulation (intervention) to standard in-person training (control). For 2 months, students were encouraged to practice the NIHSS, and both groups logged their simulations. Then, they performed a clinical proficiency test, and their results were assessed using a Bland-Altman plot with corresponding 95% limits of agreement (LoA). RESULTS: Fifty students participated in the study. Individuals in the game group (n = 23) spent an average (SD) of 42:36 min (36) on gaming and performed 14.4 (13) simulations on average, whereas the control group (n = 27) spent 9:28 min (8) simulating and performed 2.5 (1) simulations. Comparing time variables collected during the intervention period, the mean time for each simulated assessment was significantly shorter in the game group (2:57 min vs. 3:50 min, p = 0.004). In the final clinical proficiency test, the mean difference from the true NIHSS score was 0.64 (LoA: - 1.38 to 2.67) in the game group and 0.69 (LoA: - 1.65 to 3.02) in the control group. CONCLUSION: Game-based digital simulation training is a feasible alternative to standard in-person simulation training to acquire competence in NIHSS assessment. Gamification seemed to give an incentive to simulate considerably more and to perform the assessment faster, with equal accuracy. TRIAL REGISTRATION: The study was approved by the Norwegian Centre for Research Data (reference no. 543238).