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Can a single primary care paramedic configuration safely transport low-acuity patients in air ambulances?

https://arctichealth.org/en/permalink/ahliterature286059
Source
CJEM. 2017 Sep 22;:1-9
Publication Type
Article
Date
Sep-22-2017
Author
Homer Tien
Bruce Sawadsky
Michael Lewell
Sean Moore
Michael Peddle
Alun Ackery
Brodie Nolan
Russell D MacDonald
Source
CJEM. 2017 Sep 22;:1-9
Date
Sep-22-2017
Language
English
Publication Type
Article
Abstract
To 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.
We 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.
In 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.
We 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.
PubMed ID
28934993 View in PubMed
Less detail

Can a single primary care paramedic configuration safely transport low-acuity patients in air ambulances?

https://arctichealth.org/en/permalink/ahliterature303243
Source
CJEM. 2018 03; 20(2):247-255
Publication Type
Journal Article
Date
03-2018
Author
Homer Tien
Bruce Sawadsky
Michael Lewell
Sean Moore
Michael Peddle
Alun Ackery
Brodie Nolan
Russell D MacDonald
Author Affiliation
*Ornge,Mississauga,ON.
Source
CJEM. 2018 03; 20(2):247-255
Date
03-2018
Language
English
Publication Type
Journal Article
Keywords
Air Ambulances - standards
Emergencies
Emergency Medical Technicians - standards
Emergency Service, Hospital - statistics & numerical data
Female
Health Services Needs and Demand - organization & administration
Humans
Male
Middle Aged
Ontario
Retrospective Studies
Transportation of Patients - organization & administration
Abstract
To 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.
We 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.
In 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.
We 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.
PubMed ID
28934993 View in PubMed
Less detail