Titre
Lights and Siren Transport and the Need for Hospital Intervention in Nontrauma Patients: A Prospective Study
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Bertholet, Olivier
Auteure/Auteur
Pasquier, Mathieu
Auteure/Auteur
Christes, Elina
Auteure/Auteur
Wirths, Damien
Auteure/Auteur
Carron, Pierre-Nicolas
Auteure/Auteur
Hugli, Olivier
Auteure/Auteur
Dami, Fabrice
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
2090-2840
Statut éditorial
Publié
Date de publication
2020-03-16
Volume
2020
Première page
1
Dernière page/numéro d’article
6
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Résumé
The use of lights and siren transport (LST) has been a matter of debate because of the short time savings and well-established increased risks for Emergency Medical Services (EMS) and bystanders. Time-critical hospital intervention (TCHI) denotes urgently needed procedures that cannot be performed properly in an out-of-hospital setting. Since 2013, rapid transportation from the field, fast-track, is currently used for patients with acute ST-elevation myocardial infarction, suspicion of acute stroke and out-of-hospital cardiac arrest. The aim of this study was to determine whether the use of LST was associated with the realization of TCHI for nontrauma cases within 15 minutes of hospital arrival, to quantify overtriage (LST without TCHI) and to identify the predictors of TCHI.
This is a monocentric prospective observational study of nontrauma patients transported by ambulance. Based on Ross et al.'s work in 2016 on trauma patients, TCHI procedures were developed by the study team. Descriptive statistics were used to determine whether the use of LST was associated with the realization of TCHI. Multivariable analyses determined the predictors of TCHI and compared clinical outcomes.
On the 324 patients included, 67 (20.7%) benefitted from LST, with 40 (59.7%) receiving TCHI (p < 0.001). The overtriage rate was 40.3%. The most common medical TCHI was the fast-track (65.2% of all TCHI). LST was predictive of the need for TCHI (p < 0.001), as was the clinical condition of the patient and also when EMS providers expected TCHI.
A majority of the LST benefitted from TCHI with an overtriage rate of 40%. To reduce the rate of overtriage (LST without TCHI), LST should mainly be used for fast-track and when TCHI is expected by the EMS providers.
This is a monocentric prospective observational study of nontrauma patients transported by ambulance. Based on Ross et al.'s work in 2016 on trauma patients, TCHI procedures were developed by the study team. Descriptive statistics were used to determine whether the use of LST was associated with the realization of TCHI. Multivariable analyses determined the predictors of TCHI and compared clinical outcomes.
On the 324 patients included, 67 (20.7%) benefitted from LST, with 40 (59.7%) receiving TCHI (p < 0.001). The overtriage rate was 40.3%. The most common medical TCHI was the fast-track (65.2% of all TCHI). LST was predictive of the need for TCHI (p < 0.001), as was the clinical condition of the patient and also when EMS providers expected TCHI.
A majority of the LST benefitted from TCHI with an overtriage rate of 40%. To reduce the rate of overtriage (LST without TCHI), LST should mainly be used for fast-track and when TCHI is expected by the EMS providers.
PID Serval
serval:BIB_B4AA7AC379E2
PMID
Open Access
Oui
Date de création
2020-04-06T14:09:14.641Z
Date de création dans IRIS
2025-05-21T01:16:43Z
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Nom
32257445_BIB_B4AA7AC379E2.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
395.47 KB
Format
Adobe PDF
PID Serval
serval:BIB_B4AA7AC379E2.P001
URN
urn:nbn:ch:serval-BIB_B4AA7AC379E22
Somme de contrôle
(MD5):7b29ece17f9fa68839a1ac0f17d8b182