Ventilator use by emergency medical services during 911 calls in the United States

被引:9
作者
El Sayed, Mazen [1 ,2 ]
Tamim, Hani [3 ]
Mailhac, Aurelie [1 ]
Clay, Mann N. [4 ]
机构
[1] Amer Univ Beirut, Med Ctr, Dept Emergency Med, POB 11-0236, Beirut 11072020, Lebanon
[2] Amer Univ Beirut, Med Ctr, Emergency Med Serv & Prehosp Care Program, Beirut, Lebanon
[3] Amer Univ Beirut, Med Ctr, Dept Internal Med, Beirut, Lebanon
[4] Univ Utah, Sch Med, Dept Pediat, Salt Lake City, UT USA
关键词
Emergency medical services; Prehospital; Ventilator; 911; calls; NEMSIS; POSITIVE AIRWAY PRESSURE; SEVERE RESPIRATORY-DISTRESS; PREHOSPITAL TREATMENT; FAILURE; COHORT; CPAP;
D O I
10.1016/j.ajem.2017.10.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. Methods: This retrospective study used four consecutive releases of the US National Emergency Medical Services Information System(NEMSIS) public research dataset (2011-2014) to describe scene EMS activations (911 calls) with and without reported ventilator use. Results: Ventilator use was reported in 260,663 out of 28,221,321 EMS 911 scene activations (0.9%). Patients with ventilator use were older (mean age 67 +/- 18 years), nearly half were males (49.2%), mostly in urban areas (80.2%) and cared for by advanced life support (ALS) EMS services (89.5%). CPAP mode of ventilation was most common (71.6%). "Breathing problem" was the most common dispatch complaint for EMS activations with ventilator use (63.9%). Common provider impression categories included "respiratory distress" (72.5%), "cardiac rhythm disturbance" (4.6%), "altered level of consciousness" (4.3%) and "cardiac arrest"(4.0%). Ventilator use was consistently higher at the Specialty Care Transport (SCT) and Air Medical Transport (AMT) service levels and increased over the study period for both suburban and rural EMS activations. Significant factors for ventilator use included demographic characteristics, EMS agency type, specific complaints, provider's primary impressions and condition codes. Conclusions: Providers at different EMS levels use ventilators during 911 scene calls in the US. Training of prehospital providers on ventilation technology is needed. The benefit and effectiveness of this intervention remain to be assessed. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:763 / 768
页数:6
相关论文
共 15 条
[1]   ASSESSMENT OF THE ADDITION OF PREHOSPITAL CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) TO AN URBAN EMERGENCY MEDICAL SERVICES (EMS) SYSTEM IN PERSONS WITH SEVERE RESPIRATORY DISTRESS [J].
Aguilar, Steve A. ;
Lee, Jonathon ;
Castillo, Edward ;
Lam, Bryan ;
Choy, Jennifer ;
Patel, Ekta ;
Pringle, John ;
Serra, John .
JOURNAL OF EMERGENCY MEDICINE, 2013, 45 (02) :210-218
[2]   Continuous positive airway pressure and noninvasive ventilation in prehospital treatment of patients with acute respiratory failure: a systematic review of controlled studies [J].
Bakke, Skule A. ;
Botker, Morten T. ;
Riddervold, Ingunn S. ;
Kirkegaard, Hans ;
Christensen, Erika F. .
SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, 2014, 22
[3]   Variation in the Use of 12-Lead Electrocardiography for Patients With Chest Pain by Emergency Medical Services in North Carolina [J].
Bush, Montika ;
Glickman, Lawrence T. ;
Fernandez, Antonio R. ;
Garvey, J. L. ;
Glickman, Seth W. .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2013, 2 (04) :e000289
[4]   PREHOSPITAL USE OF CONTINUOUS POSITIVE AIRWAY PRESSURE FOR ACUTE SEVERE CONGESTIVE HEART FAILURE [J].
Dib, Joe E. ;
Matin, Scott A. ;
Luckert, Amy .
JOURNAL OF EMERGENCY MEDICINE, 2012, 42 (05) :553-558
[5]   Description of procedures performed on patients by emergency medical services during mass casualty incidents in the United States [J].
El Sayed, Mazen ;
Tamim, Hani ;
Mann, N. Clay .
AMERICAN JOURNAL OF EMERGENCY MEDICINE, 2015, 33 (08) :1030-1036
[6]  
Elsaadany M., 2016, PREHOSP DISASTER MED, P1
[7]   Bench-test comparison of 26 emergency and transport ventilators [J].
L'Her, Erwan ;
Roy, Annie ;
Marjanovic, Nicolas .
CRITICAL CARE, 2014, 18 (05)
[8]   Effect of Out-of-Hospital Noninvasive Positive-Pressure Support Ventilation in Adult Patients With Severe Respiratory Distress: A Systematic Review and Meta-analysis [J].
Mal, Sameer ;
McLeod, Shelley ;
Iansavichene, Alla ;
Dukelow, Adam ;
Lewell, Michael .
ANNALS OF EMERGENCY MEDICINE, 2014, 63 (05) :600-607
[9]   DESCRIPTION OF THE 2012 NEMSIS PUBLIC-RELEASE RESEARCH DATASET [J].
Mann, N. Clay ;
Kane, Lauren ;
Dai, Mengtao ;
Jacobson, Karen .
PREHOSPITAL EMERGENCY CARE, 2015, 19 (02) :232-240
[10]   Evaluation of Rural vs Urban Trauma Patients Served by 9-1-1 Emergency Medical Services [J].
Newgard, Craig D. ;
Fu, Rongwei ;
Bulger, Eileen ;
Hedges, Jerris R. ;
Mann, N. Clay ;
Wright, Dagan A. ;
Lehrfeld, David P. ;
Shields, Carol ;
Hoskins, Gregory ;
Warden, Craig ;
Wittwer, Lynn ;
Cook, Jennifer N. B. ;
Verkest, Michael ;
Conway, William ;
Somerville, Stephanie ;
Hansen, Matthew .
JAMA SURGERY, 2017, 152 (01) :11-18