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Evaluating an emergency medical services-initiated nontransport system.

Publication ,  Journal Article
Schmidt, MJ; Handel, D; Lindsell, CJ; Collett, L; Gallo, P; Locasto, D
Published in: Prehosp Emerg Care
2006

OBJECTIVE: To evaluate both factors predicting nontransport and mortality rates in an emergency medical services system with a nontransport policy. METHODS: We reviewed data from 1,581 transported and nontransported patients from October 2001 to July 2003. Patients who refused transport against medical advice were excluded. Extracted data included demographics, run characteristics, chief complaint, and clinical impression. Transported and nontransported patients were compared using Mann-Whitney U or chi-square tests. Logistic regression identified factors predictive of nontransport. A Social Security Death Index search determined 30-day mortality. RESULTS: A total of 1,501 runs involving 1,059 patients were included. Median age was 60 years (range, 0-97 years). A total of 427 (40.4%) were male; 107 (10.2%) were nonwhite. Older patients were more likely to be transported (odds ratio, 1.03; confidence interval, 1.02-1.03). Race, frequency of calls, mutual aid, or time of day did not significantly influence probability of transport. Patients with cardiovascular, respiratory, and gastrointestinal complaints were more likely to be transported than those with other conditions (P < 0.005); patients with endocrine, trauma, and miscellaneous complaints were less likely to be transported (P < 0.003). Patients with renal, obstetrics/gynecology, and hema matology/oncology were complaints all transported. Mortality was 4.9% (confidence interval, 3.9%-6.2%) for transported patients and 1.0% for those not transported (confidence interval, 0.2%-3.7%). CONCLUSIONS: Age is a determinant when deciding on transporting patients. Patients with complaints with potentially higher acuity were transported most often. Only two nontransported patients died within 30 days, although it is unknown whether initial transport would have changed their mortality. Our data suggest that emergency medical services-initiated nontransport is influenced only by age and chief complaint and may not result in significant mortality.

Duke Scholars

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Published In

Prehosp Emerg Care

DOI

ISSN

1090-3127

Publication Date

2006

Volume

10

Issue

3

Start / End Page

390 / 393

Location

England

Related Subject Headings

  • Treatment Refusal
  • Transportation of Patients
  • Ohio
  • Mortality
  • Middle Aged
  • Male
  • Logistic Models
  • Infant
  • Humans
  • Female
 

Citation

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ICMJE
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Schmidt, M. J., Handel, D., Lindsell, C. J., Collett, L., Gallo, P., & Locasto, D. (2006). Evaluating an emergency medical services-initiated nontransport system. Prehosp Emerg Care, 10(3), 390–393. https://doi.org/10.1080/10903120600725918
Schmidt, Michael J., Daniel Handel, Christopher J. Lindsell, Lindsey Collett, Paul Gallo, and Donald Locasto. “Evaluating an emergency medical services-initiated nontransport system.Prehosp Emerg Care 10, no. 3 (2006): 390–93. https://doi.org/10.1080/10903120600725918.
Schmidt MJ, Handel D, Lindsell CJ, Collett L, Gallo P, Locasto D. Evaluating an emergency medical services-initiated nontransport system. Prehosp Emerg Care. 2006;10(3):390–3.
Schmidt, Michael J., et al. “Evaluating an emergency medical services-initiated nontransport system.Prehosp Emerg Care, vol. 10, no. 3, 2006, pp. 390–93. Pubmed, doi:10.1080/10903120600725918.
Schmidt MJ, Handel D, Lindsell CJ, Collett L, Gallo P, Locasto D. Evaluating an emergency medical services-initiated nontransport system. Prehosp Emerg Care. 2006;10(3):390–393.
Journal cover image

Published In

Prehosp Emerg Care

DOI

ISSN

1090-3127

Publication Date

2006

Volume

10

Issue

3

Start / End Page

390 / 393

Location

England

Related Subject Headings

  • Treatment Refusal
  • Transportation of Patients
  • Ohio
  • Mortality
  • Middle Aged
  • Male
  • Logistic Models
  • Infant
  • Humans
  • Female