National Characteristics of Emergency Medical Services Responses for Older Adults in the United States

Hieu V. Duong, Lauren Nicholas Herrera, Justin Xavier Moore, John Donnelly, Karen E. Jacobson, Jestin N. Carlson, N. Clay Mann, Henry E. Wang

Research output: Contribution to journalArticle

Abstract

Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalPrehospital Emergency Care
Volume22
Issue number1
DOIs
StatePublished - Jan 2 2018
Externally publishedYes

Fingerprint

Emergency Medical Services
Emergencies
Young Adult
Amiodarone
Furosemide
Cardiopulmonary Resuscitation
Syncope
Nursing Homes
Heart Arrest
Atropine
Intubation
Information Systems
Epinephrine

Keywords

  • emergency medical services
  • geriatric
  • older adults
  • prehospital intervention

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency

Cite this

Duong, H. V., Herrera, L. N., Moore, J. X., Donnelly, J., Jacobson, K. E., Carlson, J. N., ... Wang, H. E. (2018). National Characteristics of Emergency Medical Services Responses for Older Adults in the United States. Prehospital Emergency Care, 22(1), 7-14. https://doi.org/10.1080/10903127.2017.1347223

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States. / Duong, Hieu V.; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E.; Carlson, Jestin N.; Mann, N. Clay; Wang, Henry E.

In: Prehospital Emergency Care, Vol. 22, No. 1, 02.01.2018, p. 7-14.

Research output: Contribution to journalArticle

Duong, HV, Herrera, LN, Moore, JX, Donnelly, J, Jacobson, KE, Carlson, JN, Mann, NC & Wang, HE 2018, 'National Characteristics of Emergency Medical Services Responses for Older Adults in the United States', Prehospital Emergency Care, vol. 22, no. 1, pp. 7-14. https://doi.org/10.1080/10903127.2017.1347223
Duong, Hieu V. ; Herrera, Lauren Nicholas ; Moore, Justin Xavier ; Donnelly, John ; Jacobson, Karen E. ; Carlson, Jestin N. ; Mann, N. Clay ; Wang, Henry E. / National Characteristics of Emergency Medical Services Responses for Older Adults in the United States. In: Prehospital Emergency Care. 2018 ; Vol. 22, No. 1. pp. 7-14.
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N2 - Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

AB - Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

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