Joseph Daniel, Vogel Jody A, Smith C Sam, Barrett Whitney, Bryskiewicz Gary, Eberhardt Aaron, Edwards David, Rappaport Lara, Colwell Christopher B, McVaney Kevin E
Prehosp Emerg Care. 2018 Jul-Aug;22(4):427-435. doi: 10.1080/10903127.2017.1413467. Epub 2018 Feb 8.
Excessive alcohol consumption is associated with a substantial number of emergency department visits annually and is responsible for a significant number of lives lost each year in the United States. However, a minimal amount is known about the impact of alcohol on the EMS system.
The primary objective was to determine the proportion of 9-1-1 calls in Denver, Colorado in which (1) alcohol was a contributing factor or (2) the individual receiving EMS services had recently ingested alcohol. The secondary objectives were to compare the characteristics of EMS calls and to estimate the associated costs.
This was a prospective observational cohort study of EMS calls for adults from July 1, 2012, to June 30, 2014. Primary outcomes for the study were alcohol as a contributing factor to the EMS call and recent alcohol consumption by the patient receiving EMS services. Logistic regression was utilized to determine the associations between EMS call characteristics and the outcomes. Cost was estimated using historic data.
During the study period, 169,642 EMS calls were completed by the Denver Health Paramedic Division. Of these 71% were medical and 29% were trauma-related. The median age was 45 (interquartile range [IQR] 29-59) years, and 55% were male. 50,383 calls (30%) had alcohol consumption, and 49,165 (29%) had alcohol as a contributing factor. Alcohol related calls were associated with male sex, traumatic injuries including head trauma, emergent response, use of airway adjuncts, cardiac monitoring, glucose measurement, use of restraints, use of spinal precautions, and administration of medications for sedation. Estimated costs to the EMS system due to alcohol intoxication exceeded $14 million dollars over the study period and required in excess of 37 thousand hours of paramedic time.
Compared to 9-1-1 calls that do not involve alcohol, alcohol-related calls are more likely to involve male patients, emergent response, traumatic injuries, advanced monitoring, airway adjuncts, and medications for sedation. This represents a significant burden on the emergency system and society. Further studies are needed to evaluate whether additional interventions such as social services could be used to lessen this burden.
每年大量急诊科就诊与过量饮酒有关，在美国，过量饮酒每年导致大量人员死亡。然而，关于酒精对急救医疗服务（EMS）系统的影响，人们了解甚少。
主要目的是确定在科罗拉多州丹佛市拨打911电话的情况中，（1）酒精是促成因素的比例，或（2）接受EMS服务的个人最近饮酒的比例。次要目的是比较EMS呼叫的特征并估计相关成本。
这是一项对2012年7月1日至2014年6月30日期间成年患者的EMS呼叫进行的前瞻性观察队列研究。该研究的主要结局是酒精作为EMS呼叫的促成因素以及接受EMS服务的患者最近饮酒情况。采用逻辑回归确定EMS呼叫特征与结局之间的关联。使用历史数据估计成本。
在研究期间，丹佛健康护理人员部门完成了169,642次EMS呼叫。其中71%为医疗呼叫，29%与创伤相关。中位年龄为45岁（四分位间距[IQR]29 - 59岁），55%为男性。50,383次呼叫（30%）涉及饮酒，49,165次呼叫（29%）酒精是促成因素。与酒精相关的呼叫与男性、包括头部创伤在内的创伤性损伤、紧急响应、使用气道辅助设备、心脏监测、血糖测量、使用约束措施、采取脊柱防护措施以及使用镇静药物有关。在研究期间，因酒精中毒给EMS系统造成的估计成本超过1400万美元，需要护理人员超过3万7千小时的时间。
与不涉及酒精的911呼叫相比，与酒精相关的呼叫更有可能涉及男性患者、紧急响应、创伤性损伤、高级监测、气道辅助设备和镇静药物。这给应急系统和社会带来了重大负担。需要进一步研究以评估是否可以采用诸如社会服务等额外干预措施来减轻这一负担。
