(O-L5) Usefulness of key word methods to execute early requests for a physician-staffed helicopter emergency medical service dispatch to facilitate early medical intervention by physicians

Saturday, September 9, 2023

10:33 AM - 10:45 AM EEST

Location: Elafos B

Oral Presenter / Primary Author(s)

Youichi Yanagawa, MD

Director
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan

Co-Author(s)

KM

Ken-ichi Muramatsu, MD

Associate professor
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan
HN

Hiroki Nagasawa, MD

Associate professor
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan
IT

Ikuto Takeuchi, MD

Associate professor
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan
YY

Yoshiko Yanagawa, RN

Register Nurse
Izu Hoken Medical Center
Izunokuni, Shizuoka, Japan
HO

Hiromichi Ohsaka, MD

Associate professor
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan
KI

Kouhei Ishikawa, MD

Associate professor
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University
Izunokuni, Shizuoka, Japan

Objectives: A physician-staffed helicopter emergency medical service (HEMS) is called a doctor helicopter (DH) in Japan. We retrospectively investigated whether or not the key words method was useful for improving the outcome of patients, using a data bank provided by the Japan DH registry system (JDRS).

Background: When a DH is dispatched to a rendezvous point, there are two dispatch subtypes: dispatch after emergency medical technicians (EMTs) make contract with a patient and determine the severity of the patient’s condition, and dispatch based on key words (ex. chest pain) to execute early requests for DH dispatch and facilitate early medical intervention by physicians. However, no study has yet investigated whether or not the key words method is useful for improving the outcome of patients.

Methods: The following details of the dispatch activity were collected: patient age and sex, vital signs (Japan Coma Scale [JCS], systolic blood pressure, heart rate, respiratory rate) on arrival, dispatch of the DH before emergency medical technicians (EMT)s made contact with patients (Key words group) or after (Control group), and the survival outcome at one month.

Results: During the investigation period, a total of 28,357 patients were enrolled as subjects (Key words group, n=13,861; Control group, n=14,496). The age, JCS, and respiratory rate were significantly smaller in the Key words group than in the Control group. The rates of male sex and the survival in the Key words group were significantly greater than in the Control group. In the multivariate analysis, dispatch of the DH after EMTs made contact with the patients (OR = 0.72, 95% CI = 0.55-0.92), female sex (OR = 0.86, 95% CI = 0.75-0.98), older age (OR = 0.97, 95% CI = 0.96-0.97), elevated respiratory rate (OR = 0.97, 95% CI = 0.97-0.98), and high JCS (OR = 0.99, 95% CI = 0.99-0.99) were associated with a decreased 1-month survival (p > 0.0001).

Conclusions: This is the first report to describe the key words method as a survival factor in patients evacuated by the DH using the JDRS. The fire-fighting central command room should consider adopting the key words method when the HEMS is used.

References (Optional):

Funding (Optional): The Promotion and Mutual Aid Corporation for Private Schools of Japan.