| Association between patient unconscious or not alert conditions and cardiac arrest or high-acuity outcomes within the Medical Priority Dispatch System "Falls" protocol. | |
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MedLine Citation:
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PMID: 20845314 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Falls are one of the most common types of complaints received by 9-1-1 emergency medical dispatch centers. They can be accidental or may be caused by underlying medical problems. Though "not alert" falls patients with severe outcomes mostly are "hot" transported to the hospital, some of these cases may be due to other acute medical events (cardiac, respiratory, circulatory, or neurological), which may not always be apparent to the emergency medical dispatcher (EMD) during call processing. OBJECTIVES: The objective of this study was to characterize the risk of cardiac arrest and "hot-transport" outcomes in patients with "not alert" condition, within the Medical Priority Dispatch System (MPDS®) Falls protocol descriptors. METHODS: This retrospective study used 129 months of de-identified, aggregate, dispatch datasets from three US emergency communication centers. The communication centers used the Medical Priority Dispatch System version 11.3-OMEGA type (released in 2006) to interrogate Emergency Medical System callers, select dispatch codes assigned to various response configurations, and provide pre-arrival instructions. The distribution of cases and percentages of cardiac arrest and hot-transport outcomes, categorized by MPDS® code, was profiled. Assessment of the association between MPDS® Delta-level 3 (D-3) "not alert" condition and cardiac arrest and hot-transport outcomes then followed. RESULTS: Overall, patients within the D-3 and D-2 "long fall" conditions had the highest proportions (compared to the other determinants in the "falls" protocol) of cardiac arrest and hot-transport outcomes, respectively. "Not alert" condition was associated significantly with cardiac arrest and hot-transport outcomes (p<0.001). CONCLUSIONS: The "not alert" determinant within the MPDS® "fall" protocol was associated significantly with severe outcomes for short falls (<6 feet; 2 meters) and ground-level falls. As reported to 9-1-1, the complaint of a "fall" may include the presence of underlying conditions that go beyond the obvious traumatic injuries caused by the fall itself. |
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Authors:
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Jeff Clawson; Christopher Olola; Greg Scott; Bryon Schultz; Richard Pertgen; Don Robinson; Barry Bagwell; Brett Patterson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prehospital and disaster medicine Volume: 25 ISSN: 1049-023X ISO Abbreviation: Prehosp Disaster Med Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-09-16 Completed Date: 2010-11-05 Revised Date: 2011-12-15 |
Medline Journal Info:
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Nlm Unique ID: 8918173 Medline TA: Prehosp Disaster Med Country: United States |
Other Details:
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Languages: eng Pagination: 302-8 Citation Subset: T |
Affiliation:
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International Academies of Emergency Dispatch, Salt Lake City, UT 84111, USA. jeff.clawson@emergencydispatch.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls Clinical Protocols / standards Emergency Medical Services / methods* Emergency Service, Hospital* Heart Arrest / complications* Humans Outcome and Process Assessment (Health Care) Retrospective Studies Risk Assessment Triage / methods* Unconsciousness / complications* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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