PDF(Pubmed)
Abstract：
UNASSIGNED: Approximately two-thirds of patients transported to emergency departments (ED) for a fall are discharged from the ED without urgent treatment. This pilot study tests the feasibility of implementing a pre-hospital falls-assessment protocol performed by emergency medical technicians (EMTs) to determine whether a patient who fell needs an ED assessment or could be referred safely to a community resource.
UNASSIGNED: The protocol was administered by trained EMTs to adults aged ≥ 65 after a fall between October 2019 and March 2020 in Sherbrooke (QC). All patients were transported to ED regardless of protocol outcome (transport recommended/not recommended). The objective was to assess if EMTs could complete the protocol and make the appropriate decision concerning the transport to ED. Secondary objectives aimed to assess the accuracy in identifying patients who do not require transport, and to measure the impact on avoidable ambulance transports.
UNASSIGNED: A total of 125 EMTs interventions were carried out: 17 patients were in the transport not recommended group, representing 14% of transport to hospital for falls-related EMTs calls that could be possibly avoided. Of these, 110 were transported to ED. Mean duration of on-site EMTs interventions was of 31 minutes. Forty-seven patients were admitted, mostly for infections and fractures, including four in the transport not recommended group.
UNASSIGNED: This study showed that EMTs can administer a falls-assessment protocol aimed at identifying patients that need an ED evaluation. Results permitted to amend the protocol before the second phase of the project evaluating the safety of the protocol.
UNASSIGNED: The protocol was administered by trained EMTs to adults aged ≥ 65 after a fall between October 2019 and March 2020 in Sherbrooke (QC). All patients were transported to ED regardless of protocol outcome (transport recommended/not recommended). The objective was to assess if EMTs could complete the protocol and make the appropriate decision concerning the transport to ED. Secondary objectives aimed to assess the accuracy in identifying patients who do not require transport, and to measure the impact on avoidable ambulance transports.
UNASSIGNED: A total of 125 EMTs interventions were carried out: 17 patients were in the transport not recommended group, representing 14% of transport to hospital for falls-related EMTs calls that could be possibly avoided. Of these, 110 were transported to ED. Mean duration of on-site EMTs interventions was of 31 minutes. Forty-seven patients were admitted, mostly for infections and fractures, including four in the transport not recommended group.
UNASSIGNED: This study showed that EMTs can administer a falls-assessment protocol aimed at identifying patients that need an ED evaluation. Results permitted to amend the protocol before the second phase of the project evaluating the safety of the protocol.
摘要：
■大约三分之二因跌倒而被送往急诊科（ED）的患者在没有紧急治疗的情况下从急诊室出院。这项试点研究测试了实施由紧急医疗技术人员（EMT）执行的院前跌倒评估协议的可行性，以确定跌倒的患者是否需要ED评估或可以安全地转诊到社区资源。
■该方案由受过训练的EMT在2019年10月至2020年3月在舍布鲁克（QC）跌倒后对≥65岁的成年人进行管理。无论方案结果如何，所有患者均被转运至ED（推荐/不推荐转运）。目的是评估EMT是否可以完成协议，并就运输到ED做出适当的决定。次要目标旨在评估识别不需要运输的患者的准确性。并测量对可避免的救护车运输的影响。
■总共进行了125例EMT干预：17例患者属于不推荐运输组，占到医院与跌倒相关的EMT呼叫的14%，这是可以避免的。其中,110人被运送到ED。现场EMT干预的平均持续时间为31分钟。四十七名病人入院,主要是感染和骨折，包括不推荐运输组中的四个。
■这项研究表明，EMT可以实施跌倒评估方案，旨在识别需要进行ED评估的患者。结果允许在评估方案安全性的项目第二阶段之前修改方案。
■该方案由受过训练的EMT在2019年10月至2020年3月在舍布鲁克（QC）跌倒后对≥65岁的成年人进行管理。无论方案结果如何，所有患者均被转运至ED（推荐/不推荐转运）。目的是评估EMT是否可以完成协议，并就运输到ED做出适当的决定。次要目标旨在评估识别不需要运输的患者的准确性。并测量对可避免的救护车运输的影响。
■总共进行了125例EMT干预：17例患者属于不推荐运输组，占到医院与跌倒相关的EMT呼叫的14%，这是可以避免的。其中,110人被运送到ED。现场EMT干预的平均持续时间为31分钟。四十七名病人入院,主要是感染和骨折，包括不推荐运输组中的四个。
■这项研究表明，EMT可以实施跌倒评估方案，旨在识别需要进行ED评估的患者。结果允许在评估方案安全性的项目第二阶段之前修改方案。
