The University of Minnesota, Minneapolis, MN; The University of Chicago, Chicago, IL.
The University of Chicago, Chicago, IL.
Air Med J. 2021 Mar-Apr;40(2):139-140. doi: 10.1016/j.amj.2020.11.011. Epub 2020 Dec 19.
EMS clinicians respond to calls in multiple types of vehicles, including ground ambulances, fixed-wing air ambulances, and rotor-wing air ambulances. Each type of vehicle serves a specific role within the overall EMS system and, based on differences in capabilities and operating costs, likely responds to patients with different clinical needs and acuities. For example, rotor-wing air ambulances are often utilized to transport high-acuity patients significant distances in less time than a ground ambulance and are staffed with highly-trained providers. To better understand the correlation between EMS vehicle type and patient acuity, we examined the National Emergency Medical Services Information System (NEMSIS) database to identify what percentage of calls involve high-acuity, medium-acuity, and low-acuity patients within three EMS vehicle types. Acuity was determined by provider impression. Of the 53,193,098 calls that were included for analysis, 99.14% involved ground ambulances, 0.75% involved rotor-wing air ambulances, and 0.11% involved fixed-wing air ambulances. Rotor-wing air ambulances received the greatest share of high-acuity patients (47.60%), followed by fixed-wing air ambulances (30.15%) and ground ambulances (3.85%). This trend was reversed for low-acuity patients: ground ambulances responded to the highest percentage of low-acuity patients (72.70%), followed by fixed-wing air ambulances (10.69%) and rotor-wing air ambulances (4.47%). These data suggest that air ambulances - both fixed-wing and rotor-wing - mostly respond to patients that providers determine to be medium-acuity or high-acuity, while a majority of calls ground ambulances respond to involve patients determined to be low-acuity. The fact that aeromedical EMS resources are predominantly being used for medium- and high-acuity patients is reassuring, because it suggests they are being effectively deployed. Further research should examine how EMS providers determine patient acuity and see if the trends we identified remain constant or fluctuate.
EMS 临床医生在多种类型的车辆中响应呼叫，包括地面救护车、固定翼空中救护车和旋翼空中救护车。每种类型的车辆在整个 EMS 系统中都有特定的作用，并且根据能力和运营成本的差异，可能会对具有不同临床需求和严重程度的患者做出响应。例如，旋翼空中救护车通常用于在比地面救护车更短的时间内将高紧急程度的患者运送到较远的地方，并且配备了经过高度训练的提供者。为了更好地了解 EMS 车辆类型与患者紧急程度之间的关系，我们检查了国家紧急医疗服务信息系统（NEMSIS）数据库，以确定三种 EMS 车辆类型中涉及高紧急程度、中紧急程度和低紧急程度患者的呼叫比例。紧急程度由提供者的印象确定。在纳入分析的 53193098 个呼叫中，99.14%涉及地面救护车，0.75%涉及旋翼空中救护车，0.11%涉及固定翼空中救护车。旋翼空中救护车接收的高紧急程度患者比例最高（47.60%），其次是固定翼空中救护车（30.15%）和地面救护车（3.85%）。对于低紧急程度患者，情况正好相反：地面救护车响应的低紧急程度患者比例最高（72.70%），其次是固定翼空中救护车（10.69%）和旋翼空中救护车（4.47%）。这些数据表明，空中救护车 - 无论是固定翼还是旋翼式 - 主要响应提供者确定为中度或高度紧急程度的患者，而大多数地面救护车响应的呼叫涉及被确定为低紧急程度的患者。事实上，航空医疗 EMS 资源主要用于中高度紧急程度的患者，这令人放心，因为这表明它们正在得到有效部署。进一步的研究应检查 EMS 提供者如何确定患者的紧急程度，并查看我们确定的趋势是否保持不变或波动。
