Section of EMS, Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06519, USA.
Prehosp Emerg Care. 2013 Jan-Mar;17(1):51-6. doi: 10.3109/10903127.2012.717168. Epub 2012 Sep 12.
Responses for "lift assists" (LAs) are common in many emergency medical services (EMS) systems, and result when a person dials 9-1-1 because of an inability to get up, is subsequently determined to be uninjured, and is not transported for further medical attention. Although LAs often involve recurrent calls and are generally not reimbursable, little is known of their operational effects on EMS systems. We hypothesized that LAs present an opportunity for earlier treatment of subtle-onset medical conditions and injury prevention interventions in a population at high risk for falls. Objectives. To quantify LA calls in one community, describe EMS returns to the same address within 30 days following an index LA call, and characterize utilization of EMS by LA patients.
Data from the computer-aided dispatch (CAD) system of a suburban fire-based EMS system were retrospectively reviewed. All LAs from 2004 to 2009 were identified using "exit codes" transmitted by paramedics after each call. The number and nature of return visits to the same address within 30 days were examined.
From 2004 through 2009, there were 1,087 LA responses (4.8% of EMS incidents) to 535 different addresses. Two-thirds of the LA calls (726; 66.8%) were to one-third of these addresses (174 addresses; 32.5%); 563 of the return calls to the same address occurred within 30 days after the index LA. For 214 of these return visits, it was possible to compare patient age and sex with those associated with the initial LA, revealing that 85% of return visits were likely for the same patients. Of these, 38.5% were for another LA/refusal of transport, 8.2% for falls and other injuries, and 47.3% for medical complaints. Hospital transport was required in 55.5% of these return visits. The EMS crews averaged 21.5 minutes out of service per LA call.
Lift-assist calls are associated with substantial subsequent utilization of EMS, and should trigger fall prevention and other safety interventions. Based on our data, these calls may be early indicators of medical problems that require more aggressive evaluation.
在许多紧急医疗服务（EMS）系统中，“升降机协助”（LA）的反应很常见，当一个人因无法起床而拨打 9-1-1 时，就会出现这种情况，随后确定没有受伤，并且不会因进一步的医疗注意而被转移。尽管 LA 通常涉及反复呼叫，并且通常不可报销，但对其对 EMS 系统的运营影响却知之甚少。我们假设，在高跌倒风险人群中，LA 提供了更早治疗微妙发作的医疗状况和预防伤害干预的机会。目的。在一个社区中量化 LA 呼叫，描述在 LA 呼叫后 30 天内对同一地址进行的 EMS 返回，并描述 LA 患者对 EMS 的利用情况。
使用 2004 年至 2009 年郊区消防为基础的 EMS 系统的计算机辅助调度（CAD）系统的数据进行回顾性审查。使用调度员在每次呼叫后传输的“退出代码”来识别所有 LA。检查 30 天内同一地址的回访次数和性质。
2004 年至 2009 年，有 1087 次 LA 响应（EMS 事件的 4.8％）到 535 个不同的地址。LA 呼叫的三分之二（726; 66.8％）来自三分之一的这些地址（174 个地址; 32.5％）; LA 后的 563 次回电均在索引 LA 后 30 天内发生。对于其中的 214 次回访，可以将患者的年龄和性别与最初的 LA 相关联，结果显示 85％的回访可能是同一患者。其中，38.5％是另一 LA/拒绝转运，8.2％是跌倒和其他伤害，47.3％是医疗投诉。这些返回访问中有 55.5％需要医院转运。每进行一次 LA 呼叫，EMS 人员平均有 21.5 分钟的服务时间。
升降机协助电话与 EMS 的大量后续使用有关，应引发跌倒预防和其他安全干预措施。根据我们的数据，这些电话可能是需要更积极评估的医疗问题的早期指标。
