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Transport outcomes and dispatch determinants in a paramedic long-term care program: a pilot study
CJEM
|June 20, 2013
Summary
The extended care paramedic (ECP) program reduced emergency department transports for long-term care patients. This pilot study showed a low relapse rate, suggesting ECPs can safely manage these patients on-site.
Area of Science:
- Emergency medicine
- Geriatric care
- Paramedic practice
Background:
- Long-term care (LTC) patients frequently utilize emergency medical services, leading to high emergency department (ED) volumes.
- Ambulance transports from LTC facilities often result in unnecessary ED visits and associated costs.
Purpose of the Study:
- To evaluate the effectiveness of an extended care paramedic (ECP) program in managing LTC patients.
- To compare dispatch determinants and patient disposition between ECPs and traditional emergency paramedics.
- To assess the impact of ECPs on ED transport rates and patient relapse.
Main Methods:
- A pilot study was conducted over 3 months in 15 LTC facilities.
- Data collected included dispatch determinants, transport rates, and relapse rates for patients attended by ECPs or emergency paramedics.
- ECP involvement in end-of-life care was also documented.
Main Results:
- ECPs attended 59% of eligible calls (140/238), while emergency paramedics attended 41% (98/238).
- In the ECP group, 70% were treated and released on-site, with only 6% requiring immediate ED transport.
- The ECP group had a low relapse rate (6%) for patients not transported, compared to zero for emergency paramedics.
Conclusions:
- ECP involvement significantly reduces ED transports for LTC patients.
- The ECP model demonstrates a low rate of patient relapse, supporting safe on-site management.
- Further research is needed to identify optimal patient populations for ECP care and analyze safe non-transport protocols.
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