TY - JOUR
T1 - National Characteristics of Emergency Medical Services Responses for Older Adults in the United States
AU - Duong, Hieu V.
AU - Herrera, Lauren Nicholas
AU - Moore, Justin Xavier
AU - Donnelly, John
AU - Jacobson, Karen E.
AU - Carlson, Jestin N.
AU - Mann, N. Clay
AU - Wang, Henry E.
N1 - Funding Information:
The NEMSIS project is a national effort to standardize EMS data collected by EMS personnel. The database is managed by the NEMSIS Technical Assistance Center (currently located at the University of Utah School of Medicine, Salt Lake City, UT) and supported by the Office of Emergency Medical Services of the National Highway Traffic Safety Administration. Local EMS agencies submit data to their State database for computation, of which a subset of data is then exported to the national database. Greater than 90% of the United States and its territories have a NEMSIS data system implemented. For this study, we used the 2014 NEM-SIS Public Release Dataset (Version 2.2.1), which contained data on almost 26 million EMS activations in 46 states and territories. The percentage of EMS agencies providing data ranged between 42 and 100%, with a few states (Arizona, Kentucky, and Louisiana) providing less than 18%. The requirements for NEMSIS data reporting vary by state (Figure 1).
Publisher Copyright:
© 2017 National Association of EMS Physicians.
PY - 2018/1/2
Y1 - 2018/1/2
N2 - Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.
AB - Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.
KW - emergency medical services
KW - geriatric
KW - older adults
KW - prehospital intervention
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U2 - 10.1080/10903127.2017.1347223
DO - 10.1080/10903127.2017.1347223
M3 - Article
C2 - 28862480
AN - SCOPUS:85028805792
SN - 1090-3127
VL - 22
SP - 7
EP - 14
JO - Prehospital Emergency Care
JF - Prehospital Emergency Care
IS - 1
ER -