Unexpected ALS Procedures on Non-Emergency Ambulance Calls: The Value of a Single-Tier System

Author:

Wilson Bryan,Gratton Matthew C.,Overton Jerry,Watson William A

Abstract

AbstractBackground:In a single-tier, advanced-life-support (ALS) emergency medical service (EMS) system, ALS-trained staff in ALS-equipped vehicles respond to all ambulance calls. In some two-tier systems, basic life support (BLS) vehicles respond to calls which are determined initially to be non-emergency based on dispatcher triage. I emergency requiring ALS is discovered (or recognized) by BLS personnel, then a subsequent ALS response can be requested.Purpose:The purpose of this study was to determine the frequency of ALS care provided on ambulance calls initially dispatched as non-emergency.Setting:A single-tier, all-ALS provider, EMS system, serving an urban population of 475,000 with an annual response volume of 45,000 calls.Methods:A retrospective review of all prehospital transports initially dispatched as non-emergency from 1 January 1989 to 1 January 1990 that resulted in an ALS intervention being performed was conducted. An ALS intervention was defined as, “administration of a medication, endotracheal intubation, attempted IV insertion, and/or ECG monitoring.”Results:A total of 6,362 non-emergency calls were identified; of these 309 (5%) were upgraded to emergency while the responding unit was in route. Of 6,053 non-emergency calls remaining, 710 (11.7%) involved the provision of one or more ALS interventions. Of these, 296 (42%) received an IV, 24 (3%) a medication, and three (0.4%) were intubated. Calls that were upgraded by dispatchers required one or more interventions in 144/309 calls (46.6%). This was statistically significantly different than for the non-upgraded calls.Conclusion:Despite the use of strict dispatching protocols, 11.7% of patients prioritized as non-emergent unexpectedly received ALS care after evaluation by ALS personnel. These results add support for the use of a single-tier, ALS ambulance system.

Publisher

Cambridge University Press (CUP)

Subject

Emergency,Emergency Medicine

Reference8 articles.

1. Characteristics of midsized urban EMS systems;Braun;Ann Emerg Med,1991

2. Cardiac arrest and resuscitation: A tale of 29 cities

3. Computer-aided EMS priority dispatch: Ability of a computerized triage system to safely spare paramedics from responses not requiring advance life support;Curka;Ann Emerg Med,1991

4. The need for ALS in urban and suburban EMS systems

Cited by 11 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Uncertainty in Facility Location Models for Emergency Medical Services;International Series in Operations Research & Management Science;2023

2. Two-Tiered Ambulance Dispatch and Redeployment considering Patient Severity Classification Errors;Journal of Healthcare Engineering;2019-12-09

3. The Vehicle Mix Decision in Emergency Medical Service Systems;Manufacturing & Service Operations Management;2016-07

4. Management of Prehospital Seizure Patients by Paramedics;Prehospital Emergency Care;2009-01

5. Emergency Medical Services;Academic Emergency Medicine;2008-09-29

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3