Paramedic intercepts with basic life support ambulance services in rural Minnesota

Area of Science:

• Emergency Medicine
• Pre-hospital Care
• Health Services Research

Background:

• Rural emergency medical services (EMS) frequently utilize paramedic intercepts, where advanced life support (ALS) meets basic life support (BLS) ambulances.
• These intercepts are intended to provide a higher level of care for specific patient needs.

Purpose of the Study:

• To analyze the frequency of paramedic intercepts in rural Minnesota.
• To evaluate the actual advanced life support (ALS) interventions provided during these intercepts.
• To assess the transport urgency (lights and sirens vs. none) in relation to care rendered.

Main Methods:

• A retrospective review of 1,675 paramedic intercepts from January 2003 to December 2007 was conducted.
• Data analyzed included ALS interventions, treatments provided, and the urgency of dispatch response and patient transport.
• The study focused on a single multi-site emergency medical services (EMS) provider.

Main Results:

• ALS ambulances responded emergently (lights and sirens) in 97.5% of intercepts but only transported 24.2% of patients emergently.
• In 11.6% of cases, paramedics provided no interventions beyond basic life support (BLS) levels.
• Among patients receiving ALS interventions, 64.4% had no treatment or diagnostics beyond electrocardiographic monitoring, intravenous access, or both.

Conclusions:

• A significant discrepancy exists between emergent responses and the level of advanced life support (ALS) care actually delivered during paramedic intercepts.
• Further research is recommended to assess the impact of decreasing emergent responses on costs and safety, considering EMS worker fatalities.
• Future directions include exploring triage protocols for advanced services and comparing patient outcomes between intercept and non-intercept cases.