Emergency medical technician treatment of hypoglycemia without transport

Strote, Jared; Simons, Ruth L.; Eisenberg, Mickey S.

doi:10.1016/j.ajem.2007.05.030

Cited by 13 publications

(14 citation statements)

References 22 publications

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“…Seventeen studies reported non-conveyance rates for specific patient populations. For patients with hypoglycaemia non-conveyance rates ranged from 12.2% up to 84.3% [32, 48, 53, 58, 59, 75]. Non-conveyance rates for people who had fallen ranged from 11%–56% [26, 27, 73, 74].…”

Section: Resultsmentioning

confidence: 99%

“…Sixteen studies combined these outcome categories, the other studies used outcomes within one category [8, 26, 28, 32, 37–40, 43–45, 48, 50, 52, 55–59, 62, 64–67, 69, 75–78, 90]. Repeated access to healthcare was specified as repeated access to (1) emergency department (2) EMS-system (call or ambulance run), (3) the general practitioner, and (4) walk-in clinic.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

Ebben

Vloet

Speijers

et al. 2017

Scand J Trauma Resusc Emerg Med

143

208

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BackgroundThis systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process.MethodsWe systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016. We included all types of peer-reviewed designs on the five topics. Couples of two independent reviewers performed the selection process, the quality assessment, and data extraction.ResultsWe included 67 studies with low to moderate quality. Non-conveyance rates for general patient populations ranged from 3.7%–93.7%. Non-conveyed patients have a variety of initial complaints, common initial complaints are related to trauma and neurology. Furthermore, vulnerable patients groups as children and elderly are more represented in the non-conveyance population. Within 24 h–48 h after non-conveyance, 2.5%–6.1% of the patients have EMS representations, and 4.6–19.0% present themselves at the ED. Mortality rates vary from 0.2%–3.5% after 24 h, up to 0.3%–6.1% after 72 h. Criteria to guide non-conveyance decisions are vital signs, ingestion of drugs/alcohol, and level of consciousness. A limited amount of non-conveyance guidelines or protocols is available for general and specific patient populations. Factors influencing the non-conveyance decision are related to the professional (competencies, experience, intuition), the patient (health status, refusal, wishes and best interest), the healthcare system (access to general practitioner/other healthcare facilities/patient information), and supportive tools (online medical control, high risk card).ConclusionsNon-conveyance rates for general and specific patient populations vary. Patients in the non-conveyance population present themselves with a variety of initial complaints and conditions, common initial complaints or conditions are related to trauma and neurology. After non-conveyance, a proportion of patients re-enters the emergency healthcare system within 2 days. For ambulance professionals the non-conveyance decision-making process is complex and multifactorial. Competencies needed to perform non-conveyance are marginally described, and there is a limited amount of supportive tools is available for general and specific non-conveyance populations. This may compromise patient-safety.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-017-0409-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

Ebben

Vloet

Speijers

et al. 2017

Scand J Trauma Resusc Emerg Med

143

208

View full text Add to dashboard Cite

show abstract

“…Previous studies looking at T + R of the acute hypoglycemic patient have found re-presentation rates between 6%-30%. [12][13][14][18][19][20] This study suggests that EMS practitioners are able to follow a T + R protocol criteria with reasonable adherence (72%, if taking into consideration technical difficulties with the EPCR system). The protocol is cautious but was designed to maximize specificity for low-risk patients.…”

Section: Discussionmentioning

confidence: 94%

A prehospital treat-and-release protocol for supraventricular tachycardia

Minhas

Vogelaar

Wang

et al. 2015

CJEM

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“…7,17,9 The differentiation was in use dextrose 10% 7 which is more likely used in Saudi Arabia, maybe because EMS is more familiar with it but in the end it dependson condition of the patient.We ran out of time, and there isa shortage of data on types of diabetes, 11 pickup locations, destination, a repeated call from the same patient, 4 follow up the patient in the hospital and the improvement of the patient status. 8 The Patient who refused transport in some cases preferred alternative transport mode or EMS deeming transfer unnecessary. The patient or who is responsible, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…The primary impression of EMS for Hypoglycemia can save the time of diagnosis and deal with the patient to avoid further injury. 8 There is a shortage of data on the characteristics of EMS performance for hypoglycemia and the rate at which patient transported to the ED. Paramedics are allowed to treat a hypoglycemic patient with intravenous Dextrose, and they use a glucometer to measure the blood glucose.…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemic Patient Transported by EMS inMakkah Region, 2017

Shammah

Mohammad

Helmi

et al. 2018

IJND

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Objective:To estimate the incident rate of the hypoglycemic patients transported by EMS and to evaluate EMS primary impression for these patients. Methods and Design: Retrospective, observational study was based on data for 150,563 SAUDI RED CRESENT AUTHORITY Transported Patients during 2017. Subjects were defined as having Hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dL Or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care settings. Results:Among 150,563 eligible encounters, 1984(1.29%) were diagnosed with hypoglycemia, of which 536 (27%) were not transported. Nontransported was more likely among male adult patients age (40-59), initial blood glucose <60 mg/dl or EMS arrival time midnight -6 A.M. Conclusion: A low rate of the non-transported patient to ED, Imperfect agreement between a primary impression of hypoglycemia and documented low blood glucose.

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Emergency medical technician treatment of hypoglycemia without transport

Cited by 13 publications

References 22 publications

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review

A prehospital treat-and-release protocol for supraventricular tachycardia

Hypoglycemic Patient Transported by EMS inMakkah Region, 2017

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