New guidelines to help operators in risk-assessment

The guidelines for handling tasks in the Emergency Response Centre Agency’s emergency medical services were revised at the end of November 2023. The change is reflected in the number of tasks assigned to emergency medical care and in the priority distribution.

Last November, the emergency medical services centres of the collaborative areas for social welfare and healthcare services gave the Emergency Response Centre Agency revised guidelines for handling prehospital emergency care tasks. The objective of the guidelines is that the task to be relayed to the prehospital emergency care services meets a genuine need. Whereas previously we prioritised speed, the focus is now on relevance. The reform is visible as a stronger direction for the patients to seek assistance independently, rather than always assigning tasks to prehospital emergency care services.

The number of assigned tasks has decreased

The implementation of the new task handling guidelines was immediately visible and the change has also been permanent. The number of tasks relayed to the prehospital emergency care services has decreased, and the share of urgent assignments of all the relayed tasks is now lower. This corresponds to the goal, i.e. directing the person requiring medical attention to receive the correct type of help already in the first stage. 

“Prehospital emergency care should primarily be reserved for sudden attacks of illness, such as myocardial infarctions or strokes and serious injuries. In other situations, the person making the emergency call may be instructed to call the Medical Helpline 116 117. The Medical Helpline 116 117 is an advisory service provided by the wellbeing services counties and the City of Helsinki to advise citizens in sudden health problems, such as various painful conditions where self-care is not sufficient,” Sector Manager Ari Ekstrand says.

A proper use of resources is for the benefit of everyone

The grounds for renewing the guidelines for handling prehospital emergency care tasks include the need to make sure that we are able to reach and treat emergency patients and to support the staggered use of emergency healthcare services (local health centre, Medical Helpline 116117, emergency department and prehospital emergency care). When resources are used correctly, help will be readily available and when needed the most. 

The change was also driven by the ERC operators’ experience with work ergonomics and how the previous guidelines for handling tasks served their needs. The change has also been evident in the ERC operations rooms. The processing times for emergency calls have increased slightly, and the operators now have the opportunity to use their professional skills more extensively to conduct a risk assessment.

Collaboration quarantees the best result

The Erica administrator for Inland Finland collaborative area, Pasi Ketola, says that there is a long process behind the change, which has taken into account many factors that contribute to the increase in the number of prehospital emergency care tasks.

“Prehospital emergency care still keeps being referred to as ambulance transport which you can just order. However, ambulance transport has evolved into a prehospital emergency care that should be targeted to those who need it the most. For example, the help required by a patient suffering from a cardiac arrest cannot be delayed because the prehospital emergency care unit is handling a task of treating a small wound that could have been treated in the emergency department where the patient could have been transported by a family member,” Pasi Ketola says.

The new guidelines for handling tasks provide more support for the operators in their decision-making in situations where a citizen calls 112 mainly because they do not know where else to call. The previous guidelines did not provide support in the same way for the decisions made on not relaying assignments, but now the instruction is to be more determined in directing those seeking medical attention to do it independently or to call the Medical Helpline 116117.

"As the number of tasks increase, it is important to direct callers to contact the correct unit immediately. This will help in avoiding resource vacuums and enabling assistance to reach the emergency patient quickly."

“The field is satisfied with the change. As the number of tasks increase, it is important to direct callers to contact the correct unit immediately. This will help in avoiding resource vacuums and enabling assistance to reach the emergency patient quickly. Above all, this is for the benefit of the person in need of assistance,” Pasi Ketola clarifies.

In order to be able to call the correct type of assistance, it also requires the emergency caller to have additional information on the task.

“It is important that the person calling for assistance answers the questions asked by the ERC operator. Only then can the ERC operator form an accurate picture of the situation and assign the correct assistance to respond to the task,” says Ari Ekstrand.

“You should not underestimate or exaggerate your symptoms during the emergency call, but provide an honest account of your current condition and answer all the questions,” Pasi Ketola adds.