appearances on ambulances: do emergency medical ...€¦ · from march 2015 to september 2015...

Objective§ Tospecificallydeterminewhethertheattire,number,and

genderofEMTSaffectpatientsduringprehospitalmedicalemergencies

Methods

Acknowledgement: This study was supported by the Rutgers Aresty Undergraduate Research Fellowship, the Bigel Endowment in Anthropology, and the Jamesburg First Aid Squad.

Background\\

§ Prehospitalmedicalcareisknowntovaryamongandwithinemergencymedicalservice(EMS)agencies

§ Emergencymedicaltechnicians(EMTs)respondingtoemergencycallscandifferintheirindividualattributes

§ ItisunknownwhethercharacteristicsofEMTsdifferentiallyinfluenceprehospitalpatientcare

Results

1Palliative and Advanced Illness Research (PAIR) Center, 2Leonard Davis Institute (LDI) of Health Economics, University of Pennsylvania; 3Rowan University School of Osteopathic Medicine; 4New Jersey State Department of Health; 5Jamaica Hospital Medical Center; 6Department of Anthropology, Rutgers University; 7Center for Bioethics and Social Sciences in Medicine (CBSSM), University of Michigan; 8Department of Social and Decision Sciences, Carnegie Mellon University

Kuldeep N. Yadav1,2, Christina A. Spoleti3, Keith R. Anacker3, Robert J. Eng4, Kinjal G. Solanki5, Susan Cachel6, Jeffrey DeWitt7, Gretchen B. Chapman8

§ Weconductedthestudyatalocalvolunteerfirst-aidsquadfromMarch2015toSeptember2015

§ EMTs’attire(e.g.,professionalorcasual)alternatedweekly,butnumberandgendervariedbythesquad’sshiftschedule

§ Emergencymedicalcallswereincludedonlyifpatientswere18+yearsold,alertandorientedx3,notgivenadvancedlifesupport(ALS),notapproachedbypoliceorfirepersonnel,andtransportedtoahospital

§ Wedichotomizedthequantityinto=2or>2EMTsandthegenderoftheEMTprimarilyßproviding patientcareintodiscordantorconcordantrelativetothegenderofpatients.

§ WeexaminedassociationsbetweenEMTs’attributesandpatients’vitalsbeforeandaftertransportthroughregressionmodels

§ 48emergencycallswereincludedinfinalanalyses

§ EMTs’attributeswereevenlydistributedamongallincludedemergencymedicalcalls§ attire:professional(n=23),casual(n=25)§ number:=2EMT (n=24),or>2EMTs(n=24)§ gender(EMT-Pt):concordant(n=26),discordant(n=22) Figure1.Variationinpatients’vitalsbyattributesofemergencymedicaltechnicians

§ WhentheEMT’sgenderwasconcordanttothatofpatients,patientsexhibitedasignificantlyhighersystolicbloodpressurereadingbeforetransport(p<0.05),butnotaftertransport(p>0.05,Figure1C)

Appearances on Ambulances: Do Emergency Medical Technicians' Attire and Gender Affect Patients' Vitals during Prehospital Medical Emergencies?

Social and Decision Sciences

§ 48emergencycallswereincludedinfinalanalyses

§ Medicalsituationsincludedgeneralpain(31%),cardiacissues(19%),respiratoryissues(15%),psychologicalevaluations(8%),andothers(27%)

§ Patients had an average age of 50 years (range=20-85 years),and 56% were female

§ Patients’meanheartratewas98.1bpmbeforetransportand92.6bpmaftertransport

§ Patients’meanbloodpressure(systolic/diastolic)was144.7/88.1mmHgbeforetransportand140.7/87.4mmHgaftertransport

§ NorelationshipsbetweentheattireornumberofEMTsandpatients’vitalswereidentified(Figure1)

Conclusions§ Whenpatientsaremostvulnerable,EMTs’gendermay

elevatepatients’systolicbloodpressure,increasingtheirrisksofcardiovascularevents(e.g.,stroke,heartattack)

§ Ourexploratoryfindingswarrantfuturecorroborationinalarger,representativesample

§ OnlythencanweexplorewaystoreduceanyundueinfluenceofEMTs’attributesonprehospitalpatientcare

Limitations§ Astudywithinasinglesmall-townfirst-aidsquadmaynot

begeneralizabletolarger,regionalEMSagencies

§ Weexcluded severalemergencyscenarios:§ patientswhodidnotrequireoractivelyrefused

medicaltransporttothehospital§ patientsinemergencysituationsthathadrequired

police,fire,orALS