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. 2024 Apr 12;32(1):27.
doi: 10.1186/s13049-024-01201-5.

Impact of delayed mobile medical team dispatch for respiratory distress calls: a propensity score matched study from a French emergency communication center

Léo Charrin  1 , Nicolas Romain-Scelle  2 , Christian Di-Filippo  1 , Eric Mercier  3 , Frederic Balen  4 , Karim Tazarourte  1 , Axel Benhamed  5   6
Affiliations

Impact of delayed mobile medical team dispatch for respiratory distress calls: a propensity score matched study from a French emergency communication center

Léo Charrin et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Shortness of breath is a common complaint among individuals contacting emergency communication center (EMCCs). In some prehospital system, emergency medical services include an advanced life support (ALS)-capable team. Whether such team should be dispatched during the phone call or delayed until the BLS-capable paramedic team reports from the scene is unclear. We aimed to evaluate the impact of delayed MMT dispatch until receiving the paramedic review compared to immediate dispatch at the time of the call on patient outcomes.

Methods: A cross-sectional study conducted in Lyon, France, using data obtained from the departmental EMCC during the period from January to December 2019. We included consecutive calls related to adult patients experiencing acute respiratory distress. Patients from the two groups (immediate mobile medical team (MMT) dispatch or delayed MMT dispatch) were matched on a propensity score, and a conditional weighted logistic regression assessed the adjusted odds ratios (ORs) for each outcome (mortality on days 0, 7 and 30).

Results: A total of 870 calls (median age 72 [57-84], male 466 53.6%) were sought for analysis [614 (70.6%) "immediate MMT dispatch" and 256 (29.4%) "delayed MMT" groups]. The median time before MMT dispatch was 25.1 min longer in the delayed MMT group (30.7 [26.4-36.1] vs. 5.6 [3.9-8.8] min, p < 0.001). Patients subjected to a delayed MMT intervention were older (median age 78 [66-87] vs. 69 [53-83], p < 0.001) and more frequently highly dependent (16.3% vs. 8.6%, p < 0.001). A higher proportion of patients in the delayed MMT group required bag valve mask ventilation (47.3% vs. 39.1%, p = 0.03), noninvasive ventilation (24.6% vs. 20.0%, p = 0.13), endotracheal intubation (7.0% vs. 4.1%, p = 0.07) and catecholamine infusion (3.9% vs. 1.3%, p = 0.01). After propensity score matching, mortality at day 0 was higher in the delayed MMT group (9.8% vs. 4.2%, p = 0.002). Immediate MMT dispatch at the call was associated with a lower risk of mortality on day 0 (0.60 [0.38;0.82], p < 0.001) day 7 (0.50 [0.27;0.72], p < 0.001) and day 30 (0.56 [0.35;0.78], p < 0.001) CONCLUSIONS: This study suggests that the deployment of an MMT at call in patients in acute respiratory distress may result in decreased short to medium-term mortality compared to a delayed MMT following initial first aid assessment.

Keywords: Advanced life support; Dyspnea; Emergency communication center; Prehospital.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map showing the distribution of MMTs and study partner hospitals
Fig. 2
Fig. 2
Flow chart of the study MMT: Mobile medical team, EMS: Emergency medical services
Fig. 3
Fig. 3
Absolute standardized mean differences COPD: chronic obstructive pulmonary disease
Fig. 4
Fig. 4
Survival between immediate and delayed mobile medical team dispatch groups
See this image and copyright information in PMC

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References

    1. Estimates of Emergency Department Visits in the United States. 2016–2021. https://www.cdc.gov/nchs/dhcs/ed-visits/index.htm. Accessed 2 Aug 2023.
    1. Kelly AM, Holdgate A, Keijzers G, Klim S, Graham CA, Craig S, et al. Epidemiology, prehospital care and outcomes of patients arriving by ambulance with dyspnoea: an observational study. Scand J Trauma Resusc Emerg Med. 2016;24:113. doi: 10.1186/s13049-016-0305-5. - DOI - PMC - PubMed
    1. Prekker ME, Feemster LC, Hough CL, Carlbom D, Crothers K, Au DH, et al. The epidemiology and outcome of prehospital respiratory distress. Acad Emerg Med. 2014;21:543–50. doi: 10.1111/acem.12380. - DOI - PMC - PubMed
    1. Kendrick KR, Baxi SC, Smith RM. Usefulness of the modified 0–10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. J Emerg Nurs. 2000;26:216–22. doi: 10.1016/S0099-1767(00)90093-X. - DOI - PubMed
    1. Saracino A, Weiland T, Dent A, Jolly B. Validation of a verbal dyspnoea rating scale in the emergency department. Emerg Med Australas. 2008;20:475–81. doi: 10.1111/j.1742-6723.2008.01132.x. - DOI - PubMed

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