@article{ref1,
title="Importance of analyzing intervals to emergency medical service treatments",
journal="Prehospital emergency care",
year="2022",
author="Ornato, Joseph P. and Dunbar, Emily G. and Harbour, Wayne and Ludin, Tom and Peberdy, Mary Ann",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BackgroundAlthough most US emergency medical services (EMS) systems collect time-to-treatment data in their electronic prehospital patient care reports (PCRs), analysis of these data seldom appears in publications. We believe EMS agencies should routinely analyze at least the initial time-to-treatment data for various potentially life-threatening conditions on quality review. This step not only assures that protocol-required treatments have been provided but can discover avoidable delays and, when necessary, drive protocol and treatment priority change.The purpose of this study was to analyze the interval from 9-1-1 call receipt until the first administration of naloxone to adult opioid overdose victims to demonstrate the quality assurance importance of analyzing time-to-treatment data.<br><br>METHODRetrospective analysis of times from 9-1-1 call receipt to initial naloxone treatment in adult opioid overdose victims treated by EMS personnel in Richmond, VA, between 1/1/19 and 10/24/21. The analysis excluded victims <18 years of age and cases where a bystander, police, or a health care worker gave naloxone before EMS arrival. We compared data collected before and during the COVID-19 pandemic to determine any effect it may have had on the analysis.<br><br>RESULTSA total of 582 opioid overdose cases were analyzed. The mean patient age was 40.7 years [95% CI 39.6, 41.8], and 405 were males (69.6%). EMS units arrived at the scene in 6.7 minutes from the 9-1-1 call receipt. It took 1.8 minutes to reach the victim, and 8.6 additional minutes to administer the first naloxone regardless of administration route (70.4% intravenous, 26.1% intranasal, 2.7% intraosseous, 0.7% intramuscular). EMS personnel administered the first naloxone 17.1 minutes after the 9-1-1 call receipt, with 50.3% of the delay occurring after EMS contacted the patient. There was no statistically significant difference in the times-to-treatment before vs. during the pandemic.<br><br>CONCLUSIONThe interval from 9-1-1 call receipt until initial EMS administration of naloxone was substantial during our analysis period and did not change significantly during the COVID-19 pandemic. We believe our findings provide an important example that supports why EMS agencies should analyze initial time-to-treatment data, especially for life-threatening conditions, beyond assuring that protocol-required treatments have been provided. Based on our analysis, fire department crews now carry intranasal naloxone, and intranasal naloxone is given to &quot;impaired&quot; opioid overdose victims by either fire department or EMS personnel, whoever arrives first. We are continuing to collect data on intervals-to-treatment prospectively and monitoring our critical process and treatment intervals. We are using the plan-do-study-act model for improving our process and carrying out a change. We plan to share our results in a future publication once we have sufficient data.<p /> <p>Language: en</p>",
language="en",
issn="1090-3127",
doi="10.1080/10903127.2022.2107124",
url="http://dx.doi.org/10.1080/10903127.2022.2107124"
}