Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.

<h4>Aims</h4>This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport.<h4>Materials and methods</h4>A state-wide, commun...

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Main Authors: Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182413&type=printable
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author Melanie Villani
Natalie Nanayakkara
Sanjeeva Ranasinha
Arul Earnest
Karen Smith
Georgia Soldatos
Helena Teede
Sophia Zoungas
author_facet Melanie Villani
Natalie Nanayakkara
Sanjeeva Ranasinha
Arul Earnest
Karen Smith
Georgia Soldatos
Helena Teede
Sophia Zoungas
author_sort Melanie Villani
collection DOAJ
description <h4>Aims</h4>This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport.<h4>Materials and methods</h4>A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted. Pre-specified variables related to patient demographics, comorbidities, examination findings, paramedic treatment and transport outcomes were obtained. Logistic regression was used to assess factors associated with transport to hospital.<h4>Results</h4>There were 11,417 cases of hyperglycaemia attended by paramedics during the study period, accounting for 0.3-0.4% of the total annual EMS caseload, and equating to 0.54 attendances per 100 people with diabetes in the state of Victoria, Australia, per year. There was a significant increase in annual utilisation, with a rate ratio of 1.62 between 2009 (2.42 cases per 10,000 population) and 2015 (3.91 cases per 10,000 population). Fifty-one percent of cases had type 2 diabetes, 37% had type 1 diabetes, 4% had diabetes with the type unspecified and 8% had no recorded history of diabetes. Ninety percent of cases were transported to hospital. Factors associated with increased odds of transport to hospital included no known history of diabetes, regional/rural locations, case time between 0600 and <1800 hours, increasing number of comorbidities and increasingly unstable vital sign observations.<h4>Conclusion</h4>There is substantial utilisation of prehospital EMS for hyperglycaemia. With increased population prevalence of diabetes predicted, further research on opportunities for prevention, as well as optimal management in the prehospital environment is warranted.
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spelling doaj-art-e58f1808676b4d94b581d6abd294eac72025-08-20T02:46:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01128e018241310.1371/journal.pone.0182413Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.Melanie VillaniNatalie NanayakkaraSanjeeva RanasinhaArul EarnestKaren SmithGeorgia SoldatosHelena TeedeSophia Zoungas<h4>Aims</h4>This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport.<h4>Materials and methods</h4>A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009-Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted. Pre-specified variables related to patient demographics, comorbidities, examination findings, paramedic treatment and transport outcomes were obtained. Logistic regression was used to assess factors associated with transport to hospital.<h4>Results</h4>There were 11,417 cases of hyperglycaemia attended by paramedics during the study period, accounting for 0.3-0.4% of the total annual EMS caseload, and equating to 0.54 attendances per 100 people with diabetes in the state of Victoria, Australia, per year. There was a significant increase in annual utilisation, with a rate ratio of 1.62 between 2009 (2.42 cases per 10,000 population) and 2015 (3.91 cases per 10,000 population). Fifty-one percent of cases had type 2 diabetes, 37% had type 1 diabetes, 4% had diabetes with the type unspecified and 8% had no recorded history of diabetes. Ninety percent of cases were transported to hospital. Factors associated with increased odds of transport to hospital included no known history of diabetes, regional/rural locations, case time between 0600 and <1800 hours, increasing number of comorbidities and increasingly unstable vital sign observations.<h4>Conclusion</h4>There is substantial utilisation of prehospital EMS for hyperglycaemia. With increased population prevalence of diabetes predicted, further research on opportunities for prevention, as well as optimal management in the prehospital environment is warranted.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182413&type=printable
spellingShingle Melanie Villani
Natalie Nanayakkara
Sanjeeva Ranasinha
Arul Earnest
Karen Smith
Georgia Soldatos
Helena Teede
Sophia Zoungas
Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
PLoS ONE
title Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
title_full Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
title_fullStr Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
title_full_unstemmed Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
title_short Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study.
title_sort utilisation of prehospital emergency medical services for hyperglycaemia a community based observational study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0182413&type=printable
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