Can a single primary care paramedic configuration safely transport low-acuity patients in air ambulances?
| Autor: | Russell D. MacDonald, Sean Moore, Bruce Sawadsky, Alun Ackery, Homer Tien, Brodie Nolan, Michael Peddle, Michael Lewell |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Staffing Crew Primary care 03 medical and health sciences Patient safety 0302 clinical medicine 030225 pediatrics medicine Ambulance service Emergency medical services Humans Decompensation Retrospective Studies Ontario Health Services Needs and Demand business.industry Air Ambulances 030208 emergency & critical care medicine Middle Aged medicine.disease Emergency Medical Technicians Transportation of Patients Emergency medicine Emergency Medicine Female Medical emergency Emergencies business Emergency Service Hospital |
| Zdroj: | CJEM. 20(2) |
| ISSN: | 1481-8043 1481-8035 |
| Popis: | ObjectiveTo determine if utilizing a single paramedic crew configuration is safe for transporting low acuity patients requiring only a primary care paramedic (PCP) level of care in Air Ambulances.MethodsWe studied single-PCP transports of low acuity patients done by contract air ambulance carriers, organized by Ornge (Ontario’s Air Ambulance Service) for one year. We only included interfacility transports. We excluded all scene calls, and all Code 4 (emergent) calls. Our primary outcome was clinical deterioration during transport. We then asked a panel to analyze each case of deterioration to determine if a dual-PCP configuration might have reasonably prevented the deterioration or have better treated the deterioration, compared to a single-PCP configuration.ResultsIn one year, contract carriers moved 3264 patients, who met inclusion criteria. 85% were from Northern Ontario. There were 21 cases of medical deterioration (0.6%±0.26%). Paper charts were found for 20 of these cases. Most were self-limited cases of pain or nausea. A small number of cases (n=5) were cardiorespiratory decompensation. There was 100% consensus amongst the panel that all cases of clinical deterioration were not related to team size. There was also 100% consensus that a dual-PCP team would not have been better able to deal with the deterioration, compared to a single-PCP crew.ConclusionsWe found that using a single-PCP configuration for transporting low acuity patients is safe. This finding is particularly important for rural areas where air ambulance is the only means for accessibility to care and where staffing issues are magnified. |
| Databáze: | OpenAIRE |
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