Abstract：
Take-home naloxone, a key response to heroin overdose, may be compromised by the way in which overdose cases are coded in EMS dispatch systems as call-takers direct callers at cardiac arrest events against using any medication. We examined the ways in which confirmed heroin overdose cases attended by ambulances are coded at dispatch to determine whether incorrect coding of overdoses as cardiac arrests may limit the use of take-home naloxone.
We conducted a retrospective analysis of coded ambulance clinical records collected in Victoria, Australia from 2012-2017. Counts of heroin overdose cases were examined by dispatch coding (heroin overdose, cardiac/respiratory arrest and \'other\'), along with age, sex, GCS and respiratory rate. Data were analysed using chi-square and Poisson regression for quarterly counts, adjusting for age, sex and patient GCS.
A total of 5637 heroin overdose cases were attended over the period 2012-2017 (71.4% male, 36.4% aged under 35 years). Almost half (n = 2674, 47.4%) were coded as cardiac/respiratory arrest at dispatch, with 36.8% (n = 2075) coded as heroin overdose and 15.7% (n = 886) coded as other/unknown.
Almost half of the heroin overdoses were dispatched according to a protocol that would preclude the use of take-home naloxone prior to ambulance arrival and this changed little over the period in which take-home naloxone programs were operating in Victoria, Australia. EMS should move as quickly as possible to newer versions of dispatch systems that enable the use of naloxone in cases of obvious opioid overdose that may be classified as cardiac/respiratory arrest.
We conducted a retrospective analysis of coded ambulance clinical records collected in Victoria, Australia from 2012-2017. Counts of heroin overdose cases were examined by dispatch coding (heroin overdose, cardiac/respiratory arrest and \'other\'), along with age, sex, GCS and respiratory rate. Data were analysed using chi-square and Poisson regression for quarterly counts, adjusting for age, sex and patient GCS.
A total of 5637 heroin overdose cases were attended over the period 2012-2017 (71.4% male, 36.4% aged under 35 years). Almost half (n = 2674, 47.4%) were coded as cardiac/respiratory arrest at dispatch, with 36.8% (n = 2075) coded as heroin overdose and 15.7% (n = 886) coded as other/unknown.
Almost half of the heroin overdoses were dispatched according to a protocol that would preclude the use of take-home naloxone prior to ambulance arrival and this changed little over the period in which take-home naloxone programs were operating in Victoria, Australia. EMS should move as quickly as possible to newer versions of dispatch systems that enable the use of naloxone in cases of obvious opioid overdose that may be classified as cardiac/respiratory arrest.
摘要：
带回家纳洛酮,对海洛因过量的关键反应，在EMS调度系统中对过量病例进行编码的方式可能会受到损害，因为呼叫接收者会在心脏骤停事件中指示呼叫者使用任何药物。我们检查了在派遣时对确认的由救护车照料的海洛因过量病例进行编码的方式，以确定由于心脏骤停而对过量的错误编码是否可能限制了带回家的纳洛酮的使用。
我们对维多利亚州收集的编码救护车临床记录进行了回顾性分析，澳大利亚从2012年到2017年。通过调度编码检查海洛因过量病例的计数(海洛因过量，心脏/呼吸骤停和\'其他\')，随着年龄的增长,性别,GCS和呼吸频率。数据采用卡方和泊松回归分析季度计数，调整年龄，性别和患者GCS。
在2012-2017年期间，共有5637例海洛因过量病例(71.4%为男性，36.4%年龄在35岁以下)。几乎一半（n=2674，47.4％）在派遣时被编码为心脏/呼吸骤停，36.8%(n=2075)编码为海洛因过量，15.7%(n=886)编码为其他/未知。
根据一项协议，几乎一半的海洛因过量是根据一项协议进行的，该协议将排除在救护车到达之前使用带回家的纳洛酮，在维多利亚州开展带回家的纳洛酮计划期间，这种情况几乎没有变化。澳大利亚。EMS应尽快转移到较新版本的调度系统，以便在明显的阿片类药物过量的情况下使用纳洛酮，这可能被归类为心脏/呼吸骤停。
我们对维多利亚州收集的编码救护车临床记录进行了回顾性分析，澳大利亚从2012年到2017年。通过调度编码检查海洛因过量病例的计数(海洛因过量，心脏/呼吸骤停和\'其他\')，随着年龄的增长,性别,GCS和呼吸频率。数据采用卡方和泊松回归分析季度计数，调整年龄，性别和患者GCS。
在2012-2017年期间，共有5637例海洛因过量病例(71.4%为男性，36.4%年龄在35岁以下)。几乎一半（n=2674，47.4％）在派遣时被编码为心脏/呼吸骤停，36.8%(n=2075)编码为海洛因过量，15.7%(n=886)编码为其他/未知。
根据一项协议，几乎一半的海洛因过量是根据一项协议进行的，该协议将排除在救护车到达之前使用带回家的纳洛酮，在维多利亚州开展带回家的纳洛酮计划期间，这种情况几乎没有变化。澳大利亚。EMS应尽快转移到较新版本的调度系统，以便在明显的阿片类药物过量的情况下使用纳洛酮，这可能被归类为心脏/呼吸骤停。
