Foster T Wynne, Matthew Turnock, Michael Crickmer, Alec H Ritchie
{"title":"由北岸救援队高级医疗服务提供者提供紧急医疗服务。","authors":"Foster T Wynne, Matthew Turnock, Michael Crickmer, Alec H Ritchie","doi":"10.1177/10806032241282963","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program is composed of physicians and nurses based in North Vancouver who attend high acuity medical search and rescue (SAR) callouts in British Columbia, Canada. This study aimed to analyze the medical care provided by AMPs with appropriate comparisons to non-AMP callouts.</p><p><strong>Methods: </strong>A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022, was conducted. The analysis included AMP involvement, rescue logistics, subject demographics, activity, primary cause, provisional diagnosis, treatments, medical decision-making, and extraction means. National Advisory Committee for Aeronautics (NACA) scores were assigned by physicians to evaluate medical acuity as well as under-triage and over-triage.</p><p><strong>Results: </strong>Of the 767 NSR callouts over the 5-year span, 283 (37%) were medical, and of these, 35% (<i>n </i>= 99) involved AMPs. Seventy-five percent of AMP rescues involved traumatic injuries, and 31% involved nontraumatic medical illnesses. The mean NACA score for AMP callouts was significantly higher than non-AMP callouts (3.1 ± 1.3 vs 1.9 ± 1.3, <i>p</i> < .00001). Medications were administered in 40% of AMP rescues, procedures were performed in 54%, and 37% involved advanced medical decision-making. Over-triage occurred in 33% of AMP callouts, with under-triage in 10%.</p><p><strong>Conclusions: </strong>The AMP program provides a useful service when advanced medical care in wilderness environments is needed. AMPs coordinate appropriate medical response and ensure safe, comfortable, and efficient transport to definitive care. The NSR AMP program may act as a model for the development of similar programs by other SAR teams.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"422-430"},"PeriodicalIF":1.4000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Emergency Medical Care Provided by North Shore Rescue Advanced Medical Providers.\",\"authors\":\"Foster T Wynne, Matthew Turnock, Michael Crickmer, Alec H Ritchie\",\"doi\":\"10.1177/10806032241282963\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program is composed of physicians and nurses based in North Vancouver who attend high acuity medical search and rescue (SAR) callouts in British Columbia, Canada. This study aimed to analyze the medical care provided by AMPs with appropriate comparisons to non-AMP callouts.</p><p><strong>Methods: </strong>A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022, was conducted. The analysis included AMP involvement, rescue logistics, subject demographics, activity, primary cause, provisional diagnosis, treatments, medical decision-making, and extraction means. National Advisory Committee for Aeronautics (NACA) scores were assigned by physicians to evaluate medical acuity as well as under-triage and over-triage.</p><p><strong>Results: </strong>Of the 767 NSR callouts over the 5-year span, 283 (37%) were medical, and of these, 35% (<i>n </i>= 99) involved AMPs. Seventy-five percent of AMP rescues involved traumatic injuries, and 31% involved nontraumatic medical illnesses. The mean NACA score for AMP callouts was significantly higher than non-AMP callouts (3.1 ± 1.3 vs 1.9 ± 1.3, <i>p</i> < .00001). Medications were administered in 40% of AMP rescues, procedures were performed in 54%, and 37% involved advanced medical decision-making. Over-triage occurred in 33% of AMP callouts, with under-triage in 10%.</p><p><strong>Conclusions: </strong>The AMP program provides a useful service when advanced medical care in wilderness environments is needed. AMPs coordinate appropriate medical response and ensure safe, comfortable, and efficient transport to definitive care. The NSR AMP program may act as a model for the development of similar programs by other SAR teams.</p>\",\"PeriodicalId\":49360,\"journal\":{\"name\":\"Wilderness & Environmental Medicine\",\"volume\":\" \",\"pages\":\"422-430\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Wilderness & Environmental Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10806032241282963\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wilderness & Environmental Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10806032241282963","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/27 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Emergency Medical Care Provided by North Shore Rescue Advanced Medical Providers.
Introduction: The North Shore Rescue (NSR) Advanced Medical Provider (AMP) program is composed of physicians and nurses based in North Vancouver who attend high acuity medical search and rescue (SAR) callouts in British Columbia, Canada. This study aimed to analyze the medical care provided by AMPs with appropriate comparisons to non-AMP callouts.
Methods: A retrospective review of all NSR callouts from January 1, 2018, to December 31, 2022, was conducted. The analysis included AMP involvement, rescue logistics, subject demographics, activity, primary cause, provisional diagnosis, treatments, medical decision-making, and extraction means. National Advisory Committee for Aeronautics (NACA) scores were assigned by physicians to evaluate medical acuity as well as under-triage and over-triage.
Results: Of the 767 NSR callouts over the 5-year span, 283 (37%) were medical, and of these, 35% (n = 99) involved AMPs. Seventy-five percent of AMP rescues involved traumatic injuries, and 31% involved nontraumatic medical illnesses. The mean NACA score for AMP callouts was significantly higher than non-AMP callouts (3.1 ± 1.3 vs 1.9 ± 1.3, p < .00001). Medications were administered in 40% of AMP rescues, procedures were performed in 54%, and 37% involved advanced medical decision-making. Over-triage occurred in 33% of AMP callouts, with under-triage in 10%.
Conclusions: The AMP program provides a useful service when advanced medical care in wilderness environments is needed. AMPs coordinate appropriate medical response and ensure safe, comfortable, and efficient transport to definitive care. The NSR AMP program may act as a model for the development of similar programs by other SAR teams.
期刊介绍：
Wilderness & Environmental Medicine, the official journal of the Wilderness Medical Society, is the leading journal for physicians practicing medicine in austere environments. This quarterly journal features articles on all aspects of wilderness medicine, including high altitude and climbing, cold- and heat-related phenomena, natural environmental disasters, immersion and near-drowning, diving, and barotrauma, hazardous plants/animals/insects/marine animals, animal attacks, search and rescue, ethical and legal issues, aeromedial transport, survival physiology, medicine in remote environments, travel medicine, operational medicine, and wilderness trauma management. It presents original research and clinical reports from scientists and practitioners around the globe. WEM invites submissions from authors who want to take advantage of our established publication''s unique scope, wide readership, and international recognition in the field of wilderness medicine. Its readership is a diverse group of medical and outdoor professionals who choose WEM as their primary wilderness medical resource.
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