Lights and Siren Transport and the Need for Hospital Intervention in Nontrauma Patients: A Prospective Study

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_B4AA7AC379E2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Lights and Siren Transport and the Need for Hospital Intervention in Nontrauma Patients: A Prospective Study
Périodique
Emergency Medicine International
Auteur(s)
Bertholet Olivier, Pasquier Mathieu, Christes Elina, Wirths Damien, Carron Pierre-Nicolas, Hugli Olivier, Dami Fabrice
ISSN
2090-2840
ISSN-L
2090-2859
Statut éditorial
Publié
Date de publication
16/03/2020
Peer-reviewed
Oui
Volume
2020
Pages
1-6
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
The use of lights and siren transport (LST) has been a matter of debate because of the short time savings and well-established increased risks for Emergency Medical Services (EMS) and bystanders. Time-critical hospital intervention (TCHI) denotes urgently needed procedures that cannot be performed properly in an out-of-hospital setting. Since 2013, rapid transportation from the field, fast-track, is currently used for patients with acute ST-elevation myocardial infarction, suspicion of acute stroke and out-of-hospital cardiac arrest. The aim of this study was to determine whether the use of LST was associated with the realization of TCHI for nontrauma cases within 15 minutes of hospital arrival, to quantify overtriage (LST without TCHI) and to identify the predictors of TCHI.
This is a monocentric prospective observational study of nontrauma patients transported by ambulance. Based on Ross et al.'s work in 2016 on trauma patients, TCHI procedures were developed by the study team. Descriptive statistics were used to determine whether the use of LST was associated with the realization of TCHI. Multivariable analyses determined the predictors of TCHI and compared clinical outcomes.
On the 324 patients included, 67 (20.7%) benefitted from LST, with 40 (59.7%) receiving TCHI (p < 0.001). The overtriage rate was 40.3%. The most common medical TCHI was the fast-track (65.2% of all TCHI). LST was predictive of the need for TCHI (p < 0.001), as was the clinical condition of the patient and also when EMS providers expected TCHI.
A majority of the LST benefitted from TCHI with an overtriage rate of 40%. To reduce the rate of overtriage (LST without TCHI), LST should mainly be used for fast-track and when TCHI is expected by the EMS providers.
Pubmed
Web of science
Open Access
Oui
Création de la notice
06/04/2020 15:09
Dernière modification de la notice
15/01/2021 7:11
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