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Rural emergency medical services are less likely to provide pain relief for trauma patients, more likely to provide adequate care to children who have an asthma attack, and are more likely to unnecessarily reduce pain, according to research published Tuesday. The use of lights and sirens is likely and adds to previous research that has revealed health conditions in rural areas. The system is more challenged than in urban and suburban areas.
important facts
A team of researchers from the Icahn School of Medicine at Mount Sinai examined every 911 emergency dispatch that occurred in the United States in 2019 (comprising more than 6 million responses from 9,679 EMS agencies), part of the National EMS Quality Alliance. EMS agencies were rated based on department. Performance measures such as effectiveness of pain management and transport of trauma patients to trauma centers.
More than half of all EMS agencies failed to meet multiple performance standards and only one in 10 followed accurate safety guidelines set, according to study results published Tuesday in Prehospital Emergency Care. .
Emergency medical services that serve predominantly rural areas are, on average, 25% more likely to use lights and sirens unnecessarily when responding to calls compared to suburban and rural emergency services. and 5% less likely to improve pain or treat hypoglycemia in trauma patients. Urban area.
Tuesday's study found that about 40% of children in all regions who suffered from an asthma attack or difficulty breathing were not treated by EMS, but children in rural areas received emergency care at a rate of about 10%. It was low.
Nearly one-third of patients across all regions with suspected stroke do not undergo a stroke assessment, which could delay patients receiving timely treatment or stop it altogether, the study says. They are thinking.
amazing facts
According to a 2017 JAMA study, the national average from 911 call to arrival at the scene is 7 minutes, but in rural areas that time doubles to 14 minutes, with about 1 in 10 encounters taking 30 minutes. .
important quotes
“Rare and serious incidents, such as when a patient's heart stops or someone suffocates, require a rapid response, but the vast majority of patients receive symptomatic clinical care in the early stages of a medical emergency. “They benefit from the care they receive,” said lead author Michael Redlener. Associate Professor at the Icahn School of Medicine at Mount Sinai said in a statement.
Main background
According to the National Institutes of Health, rural areas are often isolated from large cities and tend to have a shortage of doctors, resulting in poor or struggling health care systems. His EMS agencies in isolated areas respond to more critical and life-threatening calls that require more timely response times than his EMS providers in suburban and urban areas. The main reason is that people in rural areas are poorer, older, and more sickly. Wide geographical areas with dispersed populations, long travel distances, and difficult weather conditions and terrain all contribute to longer deployment times in rural areas, according to the federally funded Rural Health Information Hub. It is said that there is Another factor is the closure of local hospitals. According to the American Hospital Association's 2022 report, there were 136 local hospital closures between 2010 and 2021, a historic 19 in 2020 alone, the most in the past 10 years. According to a 2019 University of Kentucky study, hospital closures mean the coverage areas of those still in existence expand. Rural ambulance travel times increase by 76% in the year immediately following closure.
tangent
The use of sirens and flashing lights by ambulances has been a topic of debate within the medical community for many years. Lights and sirens are intended to reduce response and transit times, and research shows that EMS response times are “slightly” reduced by 1.7 to 3.6 minutes, and transit times are reduced by 0.7 to 3.8 minutes. However, some argue that they do more harm than good. According to the National Safety Council, the risk of an accident more than doubles when emergency vehicles use lights and sirens to transport patients. Paramedics are nearly 15 times more likely to be injured when an ambulance uses lights and sirens than when they don't. Researchers looked at how many patients who were transported using lights and sirens received an intervention at the hospital and found that only 4.5% of patients received this type of intervention. The remaining patients received paramedic intervention before arriving at the hospital, leading the researchers to say further research is needed to justify the use of lights and sirens for patients requiring hospital intervention. Recommended.
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