Emergency Medical Services (EMS) provides out-hospital treatment, although not all patients are taken to the hospital. Non-transport was an often unclear but possibly important risk factor for poor clinical outcomes. Few studies in North America have measured this risk. For a study, researchers sought to evaluate the prevalence of non-transport and 48-h adverse events (a composite of relapse responses that ended in transport or death) and identify variables related to either outcome.
In 2014, investigators examined pooled cross-sectional, population-based administrative data from the provincial EMS electronic charting system. The call outcome was used to determine non-transport. The data were searched using patient identities to establish the 48-hour adverse event rate. The logistic regression models contained paramedics reported patient, operational, and environmental factors.
Of the 74,293 emergency responses, 14,072 (18.9%) were non-transport, and 798 (5.6%) resulted in a 48-hour adverse event. Younger age (odds ratio [OR] 1.72; 99.9% CI 1.46–2.02), nonspecific paramedic clinical impression (OR 5; 99.9% CI 4.48–5.57), more than 7 comorbidities (OR 0.47; 99.9% CI 0.42–0.53), and incident location (jail) (OR 2.88; 99.9% CI 2.22–3.74) were statistically significantly and independently associated with non-transport and
The study estimated the proportion of non-transports and adverse events within 48 hours in a provincial mixed rural-urban EMS system. The study’s findings outlined the breadth of non-transport and showed many non-transport features. Future research should consider the appropriateness of EMS responses and techniques to reduce the likelihood of adverse events following non-transport.
Reference:www.jem-journal.com/article/S0736-4679(21)01054-4/fulltext
