Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System
Introduction: Emergency 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 administr...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2020-01-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/6vv7h2gj |
| _version_ | 1830275163186266112 |
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| author | Joshua Bucher David Feldman Joslyn Joseph |
| author_facet | Joshua Bucher David Feldman Joslyn Joseph |
| author_sort | Joshua Bucher |
| collection | DOAJ |
| description | Introduction: Emergency 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). Methods: The 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. Results: We 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%). Conclusion: It 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. |
| first_indexed | 2024-12-19T00:19:56Z |
| format | Article |
| id | doaj.art-a2952bd973b34efa89f0c2544d0273bc |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-12-19T00:19:56Z |
| publishDate | 2020-01-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-a2952bd973b34efa89f0c2544d0273bc2022-12-21T20:45:36ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182020-01-0121210.5811/westjem.2019.10.43885wjem-21-449Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services SystemJoshua Bucher0David Feldman1Joslyn Joseph2Rutgers - Robert Wood Johnson Medical School, Department of Emergency Medicine, New Brunswick, New JerseyMorristown Medical Center, Department of Emergency Medicine, Morristown, New JerseyNewark Beth Israel Medical Center, Department of Emergency Medicine, Newark, New JerseyIntroduction: Emergency 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). Methods: The 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. Results: We 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%). Conclusion: It 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.https://escholarship.org/uc/item/6vv7h2gj |
| spellingShingle | Joshua Bucher David Feldman Joslyn Joseph Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System Western Journal of Emergency Medicine |
| title | Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System |
| title_full | Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System |
| title_fullStr | Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System |
| title_full_unstemmed | Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System |
| title_short | Mistriaged Advanced Life Support Patients in a Two-Tiered, Suburban Emergency Medical Services System |
| title_sort | mistriaged advanced life support patients in a two tiered suburban emergency medical services system |
| url | https://escholarship.org/uc/item/6vv7h2gj |
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