The use of warning lights and siren by the ambulance crew in the Universiti Kebangsaan Malaysia Medical Centre

Ismail, Ahmad Khaldun; Salleh, Nina Ilani Mohd; Hamdan, Nur Aslina; Jawi, Masmuna Idayu Mohd; Razak, Siti Nailah Abdul; Jamal, Shamsuriani Md; Shah, Shamsul Azhar

doi:10.1097/mej.0b013e328351e62e

Cited by 8 publications

(6 citation statements)

References 0 publications

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“…The latter could be included in further research to analyze the choice of EMS transport mode.Based on our findings, LST overuse remained non-negligible, with a PPV (LST with TCHI) of only 59.7%. This was similarly described in previous studies[8,9,12,13] and confirms the need to define evidence-based protocol for guiding EMS transport practice. Regarding those results, LST for nontrauma patients should be used almost exclusively for fast-track or when EMS providers expect TCHI, taking note of traffic and weather conditions.…”

supporting

confidence: 88%

“…There is currently no consensus on what would be an appropriate use of LST from the field to the hospital, and LST criteria for use are rarely defined in EMS protocols. A relatively simple way to assess LST adequacy has been to consider it appropriate when dealing with a potentially life-threatening situation [11][12][13][14]. Some studies have applied a more comprehensive approach, using the application of time-critical hospital intervention (TCHI) as an endpoint to indicate the appropriateness of LST [2,9,10,15].…”

Section: Introductionmentioning

confidence: 99%

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Lights and Siren Transport and the Need for Hospital Intervention in Non-Trauma Patients: A Prospective Study

Bertholet

Pasquier

Christes

et al. 2019

Preprint

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Background: 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. We aimed to determine whether the use of LST was associated with the realization of TCHI for non-trauma cases within 15 minutes of hospital arrival, to identify the predictors of TCHI and to compare clinical outcomes in patients transported with or without LST. Methods: This is a monocentric prospective observational study of non-trauma patients transported by ambulance. Based on Ross et al.’s work in 2016 on trauma patients, TCHI procedures were developed by the study team. We used descriptive statistics to determine whether the use of LST was associated with the realization of TCHI. Univariate and multivariate analyses determined the predictors of TCHI and compared clinical outcomes. Results: On the 324 patients included, 67 (20.7%) benefitted from LST, with 40 (59.7%) receiving TCHI ( p < 0.001). 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. When transported with LST, patients were hospitalized significantly more often in acute care units and less often in general wards or discharged from the Emergency Department ( p < 0.001). Conclusions: The use of LST for non-trauma patients was positively associated with the realization of TCHI. EMS providers demonstrated a high level of precision in discerning which patients deserved LST. A majority of the LST benefitted from TCHI. Nevertheless, when fast-track was excluded the rate dropped by more than 50%. To reduce the rate of over-triage (LST without TCHI), LST should be used only for fast-track and also when TCHI is expected by the EMS providers.

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supporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Lights and Siren Transport and the Need for Hospital Intervention in Non-Trauma Patients: A Prospective Study

Bertholet

Pasquier

Christes

et al. 2019

Preprint

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“…(40) Using local EMS vehicles permits operation of lights and sirens, although these signals may not save time(41) and actually increase risk. (42,43) The transport environment is challenging. Hypothermia is a frequent occurrence(44) that is associated with increased mortality; using a warming mattress reduces the risk of hypothermia.…”

Section: Team Skills and Trainingmentioning

confidence: 99%

The interfacility transport of critically ill newborns

Whyte¹,

Jefferies²

2015

Paediatrics &Amp; Child Health

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The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns.

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“…ere is currently no consensus on what would be an appropriate use of LSTfrom the field to the hospital, and LST criteria for use are rarely defined in EMS protocols. A relatively simple way to assess LST adequacy has been to consider it appropriate when dealing with a potentially lifethreatening situation [11][12][13][14]. Some studies have applied a more comprehensive approach, using the application of time-critical hospital intervention (TCHI) as an endpoint to indicate the appropriateness of LST [2,9,10,15].…”

Section: Introductionmentioning

confidence: 99%

Lights and Siren Transport and the Need for Hospital Intervention in Nontrauma Patients: A Prospective Study

Bertholet

Pasquier

Christes

et al. 2020

Emergency Medicine International

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Background. 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. Methods. 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. Results. 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. Conclusions. 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.

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The use of warning lights and siren by the ambulance crew in the Universiti Kebangsaan Malaysia Medical Centre

Cited by 8 publications

References 0 publications

Lights and Siren Transport and the Need for Hospital Intervention in Non-Trauma Patients: A Prospective Study

Lights and Siren Transport and the Need for Hospital Intervention in Non-Trauma Patients: A Prospective Study

The interfacility transport of critically ill newborns

Lights and Siren Transport and the Need for Hospital Intervention in Nontrauma Patients: A Prospective Study

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