Evaluating an emergency medical services - Initiated nontransport system

Michael Schmidt, Daniel Handel, Christopher Lindsell, Lindsey Collett, Paul Gallo, Donald Locasto

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 non-transported 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.

Original languageEnglish (US)
Pages (from-to)390-393
Number of pages4
JournalPrehospital Emergency Care
Volume10
Issue number3
DOIs
StatePublished - Sep 1 2006

Fingerprint

Emergency Medical Services
Mortality
Confidence Intervals
Social Security
Chi-Square Distribution
Gynecology
Obstetrics
Logistic Models
Odds Ratio
Demography
Kidney

Keywords

  • Nontransport
  • Prehospital mortality
  • Refusal of transport

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Schmidt, M., Handel, D., Lindsell, C., Collett, L., Gallo, P., & Locasto, D. (2006). Evaluating an emergency medical services - Initiated nontransport system. Prehospital Emergency Care, 10(3), 390-393. https://doi.org/10.1080/10903120600725918

Evaluating an emergency medical services - Initiated nontransport system. / Schmidt, Michael; Handel, Daniel; Lindsell, Christopher; Collett, Lindsey; Gallo, Paul; Locasto, Donald.

In: Prehospital Emergency Care, Vol. 10, No. 3, 01.09.2006, p. 390-393.

Research output: Contribution to journalArticle

Schmidt, M, Handel, D, Lindsell, C, Collett, L, Gallo, P & Locasto, D 2006, 'Evaluating an emergency medical services - Initiated nontransport system', Prehospital Emergency Care, vol. 10, no. 3, pp. 390-393. https://doi.org/10.1080/10903120600725918
Schmidt M, Handel D, Lindsell C, Collett L, Gallo P, Locasto D. Evaluating an emergency medical services - Initiated nontransport system. Prehospital Emergency Care. 2006 Sep 1;10(3):390-393. https://doi.org/10.1080/10903120600725918
Schmidt, Michael ; Handel, Daniel ; Lindsell, Christopher ; Collett, Lindsey ; Gallo, Paul ; Locasto, Donald. / Evaluating an emergency medical services - Initiated nontransport system. In: Prehospital Emergency Care. 2006 ; Vol. 10, No. 3. pp. 390-393.
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