National Characteristics of Non-Transported Children by Emergency Medical Services in the United States.
National Characteristics of Non-Transported Children by Emergency Medical Services in the United States.
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DOI：
10.1080/10903127.2021.1985666
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发表时间：
2022-07
影响因子：
2.4
通讯作者：
Chamberlain, James
中科院分区：
文献类型：
--
作者：
Ward, Caleb;Zhang, Anqing;Brown, Kathleen;Simpson, Joelle;Chamberlain, James
大多数911电话导致救护车运送到急诊室。在某些情况下，运输被拒绝或被认为没有必要。儿科非转运的频率未知。我们的主要目的是描述儿科EMS激活导致非转运的比例。我们的次要目标是确定与儿科非转运相关的患者、社区和EMS机构因素。我们使用来自国家EMS信息系统登记处的2019年数据进行了一项横断面研究。我们比较了儿童（< 18岁）、成人（18 - 60岁）和老年（>60岁）患者的非转运率。然后，我们使用广义估计方程来确定与儿科非运输相关的因素，同时考虑地理聚类。有21，931，490例EMS激活，包括1，403，454例儿科911应答。30%的儿科911响应导致非运输。成人（19%，OR 0.54 [0.54，0.55]）和老年患者（13%，OR 0.35 [0.35，0.36]）的非转运可能性较小。最常见的儿科非转运处置是：拒绝评价/护理和治疗/出院。非转运与以下主诉相关：肺部（aOR 3.84 [3.30，4.48]）和肌肉骨骼主诉（aOR 3.75 [3.22，4.36]）。非运输更可能发生在：农村EMS呼叫（aOR 1.28 [1.24，1.32]）; EMS分类为低视力的呼叫（aOR 7.88 [5.98，10.38]）;和部落EMS机构（aOR 3.49 [3.09，3.94]）。几乎三分之一的儿科911激活导致非运输。虽然迄今为止，很少有儿童被纳入替代性运输程序的试点，但实际上，非运输在儿童中比在成人中更为常见。需要做更多的工作来更好地了解这种做法的患者安全和经济影响。
Most 911 calls result in ambulance transport to an emergency department. In some cases, transport is refused or deemed unnecessary. The frequency of pediatric non-transport is unknown. Our primary objective was to describe the proportion of pediatric EMS activations resulting in non-transport. Our secondary objective was to identify patient, community, and EMS agency factors associated with pediatric non-transport. We conducted a cross-sectional study using 2019 data from the National EMS Information System registry. We compared non-transport rates for children (< 18 y/o), adults (18 – 60 y/o) and elderly (>60 y/o) patients. We then used generalized estimating equations to identify factors associated with pediatric non-transport while accounting for geographical clustering. There were 21,931,490 EMS activations, including 1,403,454 pediatric 911 responses. 30% of pediatric 911 responses resulted in non-transport. Non-transport was less likely for adults (19%, OR 0.54 [0.54, 0.55]) and elderly patients (13%, OR 0.35 [0.35, 0.36]). The most common pediatric non-transport dispositions were: refused evaluation/care, and treated/released. Non-transport was associated with: pulmonary (aOR 3.84 [3.30, 4.48]) and musculoskeletal chief complaints (aOR 3.75 [3.22, 4.36]). Non-transport was more likely for: rural EMS calls (aOR 1.28 [1.24, 1.32]); calls classified by EMS as Lower Acuity (aOR 7.88 [5.98, 10.38]); and Tribal EMS agencies (aOR 3.49 [3.09, 3.94]). Almost one-third of pediatric 911 activations result in non-transport. Although very few children have been included in pilots of alternate transport processes to date, non-transport is actually more common in children than adults. More work is needed to understand better the patient safety and economic implications of this practice.
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影响因子：
2.4
作者：
Hansen M;Meckler G;Dickinson C;Dickenson K;Jui J;Lambert W;Guise JM
通讯作者：
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2.4
作者：
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