Jarvis Jeffrey L, Hamilton Vaughn, Taigman Mike, Brown Lawrence H
Prehosp Emerg Care. 2021 Jul-Aug;25(4):549-555. doi: 10.1080/10903127.2020.1797963. Epub 2020 Aug 7.
Emergency Medical Services (EMS) often respond to 911 calls using red lights and sirens (RLS). RLS is associated with increased collisions and increased injuries to EMS personnel. While some patients might benefit from time savings, there is little evidence to guide targeted RLS response strategies.
To describe the frequency and nature of 911 calls that result in potentially life-saving interventions (PLSI) during the call.
Using data from ESO (Austin, Texas, USA), a national provider of EMS electronic health records, we analyzed all 911 calls in 2018. We abstracted the use of RLS, call nature, and interventions performed. A liberal definition of PLSI was developed a priori through a consensus process and included both interventions, medications, and critical hospital notifications. We calculated the proportion of calls with RLS response and with PLSI performed, both overall and stratified by call nature.
There were 5,977,612 calls from 1,187 agencies included in the analysis. The majority (85.8%) of calls utilized RLS, yet few (6.9%) resulted in PLSI. When stratified by call nature, cardiac arrest calls had the highest frequency PLSI (45.0%); followed by diabetic problems (37.0%). Glucose was the most frequently given PLSI, = 69,036. When including multiple administrations to the same patient, epinephrine was given most commonly PLSI, = 157,282 administrations).
In this large national dataset, RLS responses were very common (86%) yet potentially life-saving interventions were infrequent (6.9%). These data suggest a methodology to help EMS leaders craft targeted RLS response strategies.
紧急医疗服务（EMS）在应对911报警电话时经常使用红灯和警笛（RLS）。RLS与碰撞增加以及EMS人员受伤增加有关。虽然一些患者可能会从节省时间中受益，但几乎没有证据可指导有针对性的RLS响应策略。
描述在通话期间导致潜在挽救生命干预措施（PLSI）的911报警电话的频率和性质。
利用美国德克萨斯州奥斯汀市的ESO（一家全国性的EMS电子健康记录提供商）的数据，我们分析了2018年所有的911报警电话。我们提取了RLS的使用情况、通话性质以及所采取的干预措施。通过共识过程预先制定了对PLSI的宽泛定义，包括干预措施、药物以及关键的医院通知。我们计算了总体上以及按通话性质分层的使用RLS响应的电话比例和进行了PLSI的电话比例。
分析纳入了来自1187个机构的5977612个电话。大多数（85.8%）电话使用了RLS，但很少（6.9%）导致PLSI。按通话性质分层时，心脏骤停电话的PLSI频率最高（45.0%）；其次是糖尿病问题（37.0%）。葡萄糖是最常给予的PLSI，=69036。当包括对同一患者的多次给药时，肾上腺素是最常给予的PLSI，=157282次给药）。
在这个大型的全国数据集中，RLS响应非常普遍（86%），但潜在挽救生命的干预措施很少（6.9%）。这些数据提示了一种方法，可帮助EMS领导者制定有针对性的RLS响应策略。
