Vaughn Alexandra, Levy Matthew J, Paul-Schultz Jenna, Melvin Lia, Scharf Becca, Margolis Asa, Jenkins J Lee
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
Department of Fire and Rescue Services, Howard County Maryland, Marriottsville, USA.
Cureus. 2024 Dec 10;16(12):e75481. doi: 10.7759/cureus.75481. eCollection 2024 Dec.
Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data exists regarding EMS activations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies. Methods EMS activations originating from outdoor recreational areas and parks in Howard County, Maryland, between December 2018 and December 2022, were extracted from the Howard County Department of Fire and Rescue Services (HCDFRS) electronic medical records database. Patient complaints were categorized into medical or traumatic etiologies and then determined to be "time-critical" or "non-time-critical" by two emergency physician reviewers with a tie-breaker reviewer to resolve discrepancies. Results A total of 396 EMS activations in county parks and recreational areas were recorded during the study period, with 61 (15.40%) determined to be time-critical. The most commonly occurring time-critical calls were cardiac arrest (7; 11.48%), drug/alcohol-related complaints (5; 8.20%), and altered mental status (5; 4.92%). Most EMS activations were for male patients (273; 68.94%). Pediatric patients (<18 years old) constituted 161 (40.66%) time-critical traumatic injury activations, and these numbers decreased as patient age increased. The most commonly occurring time-critical medical activations (11; 2.78%), occurred in 40-64-year-olds. The highest number of total EMS activations occurred in October, with 57 calls (14.39%), and the greatest volume of time-critical activations occurred during June, with nine calls (14.75%). Conclusion Within a suburban county's EMS system, 15.4% of the total EMS activations to parks and outdoor recreational locations were found to be time-critical, significantly higher than in other places. Patients aged 0-18 experienced the highest number of time-critical trauma-related activations, whereas those aged 40-64 had the highest number of time-critical medical activations. EMS agencies should review their activation rates in these locations to determine the need to enhance education and operational readiness for response to time-critical activations for pediatric trauma and adult medical emergencies.
目的 先前的研究描述了美国国家公园内紧急医疗服务（EMS）启动的模式。然而，关于当地和区域户外休闲场所的EMS启动数据却很少。我们对马里兰州霍华德县郊区公园和休闲区的EMS启动情况进行了回顾性分析，以描述那些被确定为时间紧迫型紧急情况的启动特征。方法 从霍华德县消防与救援服务部（HCDFRS）电子病历数据库中提取2018年12月至2022年12月期间源自马里兰州霍华德县户外休闲区和公园的EMS启动记录。患者投诉被归类为医疗或创伤性病因，然后由两名急诊医生评审员判定为“时间紧迫型”或“非时间紧迫型”，如有分歧则由一名决胜评审员解决。结果 在研究期间，共记录了396次县公园和休闲区的EMS启动，其中61次（15.40%）被判定为时间紧迫型。最常出现的时间紧迫型呼叫是心脏骤停（7次；11.48%）、药物/酒精相关投诉（5次；8.20%）和精神状态改变（5次；4.92%）。大多数EMS启动是针对男性患者（273次；68.94%）。儿科患者（<18岁）占161次（40.66%）时间紧迫型创伤性损伤启动，且随着患者年龄增加，这些数字减少。最常出现的时间紧迫型医疗启动（11次；2.78%）发生在40 - 64岁人群中。EMS启动总数最高的月份是10月，有57次呼叫（14.39%），时间紧迫型启动量最大的月份是6月，有9次呼叫（14.75%）。结论 在一个郊区县的EMS系统中，发现前往公园和户外休闲场所的EMS启动总数中有15.4%是时间紧迫型的，显著高于其他地方。0 - 18岁的患者经历的时间紧迫型创伤相关启动次数最多，而40 - 64岁的患者时间紧迫型医疗启动次数最多。EMS机构应审查这些场所的启动率，以确定是否需要加强针对儿科创伤和成人医疗紧急情况的时间紧迫型启动的教育和应急准备工作。
