Abstract
IntroductionEmergency medical services (EMS) systems exist to provide prehospital care in diverse environments throughout the world. Advanced Life Support (ALS) services can provide advanced care including 12-lead electrocardiogram (ECG), endotracheal intubation and parenteral medication administration. Basic Life Support (BLS) can provide basic care such as splinting, wound care and cardiopulmonary resuscitation. ALS can release patients to BLS for transport to the hospital, and this is an area of high risk. Our study examines patients who were triaged and admitted to a critical care location, including an intensive care unit (ICU), cardiac catheterization laboratory, or operating room (OR).MethodsThe analysis included data from 2007–2015 of all patients who were triaged. We evaluated demographics, admission diagnoses, and dispositions using descriptive statistics. Diagnoses were grouped into categories based on the system.ResultsWe found that 372/17,639 (2%) of patients were mistriaged to BLS and admitted to a critical care location. The average age was 64. The most common diagnosis categories were neurological (24%), gastrointestinal (GI)/abdominal pain (15%), respiratory (12%), and cardiac (12%).ConclusionIt is uncommon for patients triaged from ALS to BLS to be admitted to an ICU, catheterization lab or OR, with a rate of 2%. Neurological, GI, respiratory, and cardiac diagnoses were the most frequent categories of patient complaints that were mistriaged. This study should lead to further studies to examine this patient population.
Highlights
Emergency medical services (EMS) systems exist to provide prehospital care in diverse environments throughout the world
We found that 372/17,639 (2%) of patients were mistriaged to Basic Life Support (BLS) and admitted to a critical care location
It is uncommon for patients triaged from Advanced Life Support (ALS) to BLS to be admitted to an intensive care unit (ICU), catheterization lab or operating room (OR), with a rate of 2%
Summary
Emergency medical services (EMS) systems exist to provide prehospital care in diverse environments throughout the world. ALS can release patients to BLS for transport to the hospital, and this is an area of high risk. Many different emergency medical services (EMS) systems exist in order to serve diverse patient populations. One of the systems in the United States uses a two-tiered response comprised primarily of a Basic Life Support (BLS) transport ambulance staffed by emergency medical technicians (EMT) and Advanced Life Support (ALS) staffed by two paramedics. With more ambulances available to respond to simultaneous patients in high-volume areas, response times to critical intervention such as cardiopulmonary resuscitation and stabilization of trauma patients may be decreased.[1] One challenge of EMS is determining which patients truly require ALS pre-hospital care. ALS interventions have shown to provide some mortality benefit to patients
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