Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T06:25:41.324Z Has data issue: false hasContentIssue false
  • English
  • Français

Paramedic On Scene Time for Patients Initially Refusing Treatment or Transport

Published online by Cambridge University Press:  28 June 2012

John M. Heiser ,
Robert L. Norton ,
Keith W. Neely ,
Joe Acker  and
Jerris R. Hedges
John M. Heiser
Affiliation:
Oregon Health Sciences University
Robert L. Norton
Affiliation:
Oregon Health Sciences University
Keith W. Neely
Affiliation:
Oregon Health Sciences University
Joe Acker
Affiliation:
Multnomah County EMS Office
Jerris R. Hedges*
Affiliation:
Oregon Health Sciences University
*
Division of Emergency Medicine Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97201-3098, (503) 494-7500
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Patients initially refusing care (PIRC) place their health in jeopardy and consume paramedic and base-station physician time. This study quantifies the time spent on-scene related to PIRC cases.

Methods:

A retrospective analysis of 128 PIRC cases was performed in the Multomah County EMS system.

Results:

The PIRC cases had a significantly longer mean on-scene time than did non-refusal cases (30.3 vs 14.6 min; p<.001). Medication administration by paramedics (14% of patients) significantly increased the on-scene time. Overall, the mean time on-scene was not affected by age, gender, vital signs (pulse, blood pressure, respiratory rate), police involvement, and whether the patient was transported. The type of call had limited influence on on-scene time, although mean on-scene time was significantly longer for altered mental status cases than for trauma related cases (35.6 vs 22.4 min; p<.03).

Conclusions:

PIRC cases create a burden on the EMS system by consuming paramedic and base-station physician time and by preventing these personnel from responding to other calls.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 6 , Issue 3 , September 1991 , pp. 293 - 297
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 6th Annual Conference of the National Association of Emergency Medical Services Physicians, Houston, Texas, June 13–16, 1990

References

1. Braun, O, McCallion, R, Fazackerley, J: Characteristics of midsized urban EMS system. Ann Emerg Med 1990;19:536–546.CrossRefGoogle Scholar
2. Selden, BS, Schnitzer, PG, Nolan, FX: Medicolegal documentation of prehospital triage. Ann Emerg Med 1990;19:547–551.CrossRefGoogle ScholarPubMed
3. Soler, JM, Montes, MF, Egol, AB, et al. : The ten-year malpractice experience of a large, urban EMS system. Ann Emerg Med 1985;14:982–985.CrossRefGoogle ScholarPubMed
4. Goldberg, RJ, Zantcke, JL, Koenigsberg, MD, et al. : A review of prehospital case litigation in a metropolitan EMS system. Ann Emerg Med 1990;19:557–561.CrossRefGoogle Scholar
5. Stark, G, Hedges, JR, Neely, K, et al. : Patients who refuse prehospital evaluation and/or therapy. Am J Emerg Med 1990;8:509–511.CrossRefGoogle ScholarPubMed
6. Hedges, JR, Heiser, JM, Neely, KW, et al. : Analysis of base-station morphine orders: assessment of supervising physician consistency. J Emerg Med 1990;8:587–590.CrossRefGoogle ScholarPubMed