Emergency medical services responses to 9-1-1 calls triggered by personal emergency response systems.

Abstract

Objectives: Many elderly adults utilize wearable personal emergency response systems (PERS) to support independent living while ensuring prompt assistance in an emergency. Activation of emergency medical services (EMS) is integral to the PERS model, but the impact of PERS activation on the utilization of EMS is not well described. We examined EMS responses to 9-1-1 calls related to PERS activations in a large EMS system over a ten-year period and evaluated the appropriateness of lights and siren (L&S) response.

Methods: This retrospective analysis included 9-1-1 responses to PERS activations by a single agency between January 1, 2013, and December 31, 2022. Descriptive statistics were used to summarize the chief complaint assigned by the emergency medical dispatcher (EMD), response mode, and transport mode. Logistic regression was used to assess the association between EMD-assigned final chief complaint and L&S patient transport. Duration of L&S response (minutes) was computed as the interval between time unit dispatched and either unit arrival (patient contact), or unit cancellation (no patient contact).

Results: Activations related to PERS (n = 18,660) comprised 2.5% of all 9-1-1 calls involving adult patients. Lights and siren were used in 96% of PERS responses, and patient contact, patient transport, and L&S transport occurred in 36%, 25%, and 1.4%, respectively. Patients evaluated by EMS were most often female (72%) and ages 85+ (39%). Dispatcher modification of the chief complaint from PERS alarm to a more clinically specific complaint code was univariately associated with an increased odds of L&S transport (OR = 2.85, CI = 2.10-3.87). Between 2013 and 2022, responses to PERS activations accounted for 1,734 hours of L&S use, of which 1,087 hours (63%) were attributable to calls cancelled prior to patient contact.

Conclusions: A significant proportion of PERS responses in this system are cancelled prior to patient contact or involve low acuity patients, and L&S patient transport is rare. Dispatcher determination of the specific nature of the problem increases the likelihood of the need for L&S transport after PERS activations. These findings provide a strong rationale for EMS systems transitioning away from the use of L&S response to PERS calls in the absence of definitive situational information.