Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada.
Wilderness Environ Med. 2024 Dec;35(4):422-430. doi: 10.1177/10806032241282963. Epub 2024 Sep 27.
The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program is composed of physicians and nurses based in North Vancouver who attend high acuity medical search and rescue (SAR) callouts in British Columbia, Canada. This study aimed to analyze the medical care provided by AMPs with appropriate comparisons to non-AMP callouts.
A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022, was conducted. The analysis included AMP involvement, rescue logistics, subject demographics, activity, primary cause, provisional diagnosis, treatments, medical decision-making, and extraction means. National Advisory Committee for Aeronautics (NACA) scores were assigned by physicians to evaluate medical acuity as well as under-triage and over-triage.
Of the 767 NSR callouts over the 5-year span, 283 (37%) were medical, and of these, 35% (= 99) involved AMPs. Seventy-five percent of AMP rescues involved traumatic injuries, and 31% involved nontraumatic medical illnesses. The mean NACA score for AMP callouts was significantly higher than non-AMP callouts (3.1 ± 1.3 vs 1.9 ± 1.3, < .00001). Medications were administered in 40% of AMP rescues, procedures were performed in 54%, and 37% involved advanced medical decision-making. Over-triage occurred in 33% of AMP callouts, with under-triage in 10%.
The AMP program provides a useful service when advanced medical care in wilderness environments is needed. AMPs coordinate appropriate medical response and ensure safe, comfortable, and efficient transport to definitive care. The NSR AMP program may act as a model for the development of similar programs by other SAR teams.
北岸救援（NSR）高级医疗提供者（AMP）计划由北温哥华的医生和护士组成，他们负责处理不列颠哥伦比亚省高风险的医疗搜索和救援（SAR）呼叫。本研究旨在分析 AMP 提供的医疗服务，并与非 AMP 呼叫进行适当比较。
对 2018 年 1 月 1 日至 2022 年 12 月 31 日期间所有 NSR 呼叫进行回顾性分析。分析包括 AMP 参与情况、救援物流、对象人口统计学特征、活动、主要原因、临时诊断、治疗、医疗决策和提取方法。医生对国家航空咨询委员会（NACA）评分进行评估，以评估医疗紧迫性以及分诊不足和过度分诊。
在 5 年期间，767 次 NSR 呼叫中有 283 次（37%）为医疗呼叫，其中 35%（99 次）涉及 AMP。75%的 AMP 救援涉及创伤性损伤，31%涉及非创伤性医疗疾病。AMP 呼叫的平均 NACA 评分明显高于非 AMP 呼叫（3.1±1.3 比 1.9±1.3， < .00001）。在 AMP 救援中，40%的患者接受了药物治疗，54%的患者进行了治疗，37%的患者进行了高级医疗决策。AMP 呼叫中有 33%的患者出现过度分诊，10%的患者出现分诊不足。
当需要在野外环境中提供高级医疗服务时，AMP 计划提供了有用的服务。AMP 协调适当的医疗反应，并确保安全、舒适和高效地转运至确定性治疗。NSR AMP 计划可为其他 SAR 团队开发类似计划提供模型。
