El Sayed Mazen, Tamim Hani, Mann N Clay
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Am J Emerg Med. 2015 Aug;33(8):1030-6. doi: 10.1016/j.ajem.2015.04.035. Epub 2015 Apr 25.
Emergency medical services (EMS) preparedness is essential to reduce morbidity and mortality from mass casualty incidents (MCIs).
We sought to describe types and frequencies of common procedures performed during MCIs by EMS providers at different service levels.
This study was carried out using the 2012 US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System. Emergency medical services activations coded as MCI at dispatch or by EMS personnel were included. The Center for Medicare and Medicaid Services service level was used for the level of service provided. A descriptive analysis characterizing the most common procedure types and frequencies by service level was carried out.
Among the 19831189 EMS activations in the 2012 national data set, 53334 activations had an MCI code, of which 26110 activations were included. There were 8179 advanced life support (31.3%), 5811 basic life support (22.3%), 399 air medical transport (air transport fixed or rotary) (1.5%), and 38 specialty care transport (0.2%) activations. A total of 107 different procedure types were reported. The most common procedures by procedure count were "spine immobilization" (21.8%) followed by "venous access extremity" (14.1%) and "assessment adult" (13.4%). A similar order was found for procedure frequencies by included EMS activations (24.1%, 19.3%, and 18.3%, respectively). Top 20 procedures had different frequencies by levels of care except for "medical director control" (P = .19).
Advanced EMS interventions are not frequent during MCIs in the United States. Emergency medical services systems with other types of providers or MCI response patterns might report different findings.
应急医疗服务（EMS）准备工作对于降低大规模伤亡事件（MCI）的发病率和死亡率至关重要。
我们试图描述不同服务水平的EMS提供者在MCI期间执行的常见程序的类型和频率。
本研究使用由国家应急医疗服务信息系统维护的2012年美国国家EMS公开发布研究数据集进行。包括调度时或EMS人员编码为MCI的应急医疗服务启动。医疗保险和医疗补助服务中心的服务水平用于所提供的服务级别。对按服务水平划分的最常见程序类型和频率进行了描述性分析。
在2012年国家数据集中的19831189次EMS启动中，53334次启动有MCI代码，其中26110次启动被纳入。有8179次高级生命支持（31.3%）、5811次基本生命支持（22.3%）、399次空中医疗运输（固定翼或旋翼空中运输）（1.5%）和38次专科护理运输（0.2%）启动。总共报告了107种不同的程序类型。按程序计数最常见的程序是“脊柱固定”（21.8%），其次是“四肢静脉通路”（14.1%）和“成人评估”（13.4%）。按纳入的EMS启动计算的程序频率也发现了类似的顺序（分别为24.1%、19.3%和18.3%）。除“医疗主任控制”外，前20种程序在不同护理级别下的频率不同（P = 0.19）。
在美国，MCI期间高级EMS干预并不频繁。具有其他类型提供者或MCI应对模式的应急医疗服务系统可能会报告不同的结果。
