Incident Disposition Summary FY205 Quarter 3 (January March, 205). Total number of reports filed (as reported) i : 6,488 2. Total number of reports reviewed (as reported): 3,82 3. Level of Care ii : a. ALS: 2,56 b. BLS: 2,448 c. N/A:,462 No Patient Found, 277 N/A, 67 Unknown, 25 Dead on Scene, 8 Cancelled, 735 Patient Refusal, 62 Treated and Transported, 4062 No Treatment, 85 Treated and Released, 44 Private Transport, 6 Treated and Transferred, 277 4. Incident Disposition: a. Treated & Transported: 4,062 b. Treated & Transferred: 277 c. Treated, Transported by Private: 6 d. Treated & Released: 44 e. No Treatment Required: 85 f. Patient Refusal: 62 g. Dead on Scene: 8 h. Cancelled: 735 i. No Patient Found: 277 j. Not Applicable: 67 k. Unknown: 25 i This, of course, does not include non-compliant agencies and agencies which failed to complete this section of the data form. ii As usual, these numbers do not all add up nicely. I believe that better instructions need to be issued regarding the completion of the data sheet until such a time that all of this information may be pulled from VPHIB.
Medical Indicator Summary and Report Pain Management Survey:. Total number of reported pain management cases i : 44 Pain Management Cases - Drugs Administered, 0% 7, 9% 84, 46% 3, 7% 4, 8% 3, 7%, 0%, % 34, 9%, %, %, % Acetaminophen ASA Combination Diazepam Etomidate Fentanyl Ibuprofen Ketamine Medcal Morphine Nitro Oxygen a. Total cases with pharmacological intervention ii : 8 i. Acetaminophen: ii. ASA: 4 iii. Combination iii : 3 iv. Diazepam: v. Etomidate: vi. Fentanyl: 34 vii. Ibuprofen: viii. Ketamine: ix. Medcal: x. Morphine: 84 xi. Nitroglycerin: 7 xii. Oxygen: 3
Medical Indicator Summary and Report b. Most Common Dosage (3 rd Quarter): i. Acetaminophen: 650 mg ii. ASA: 324 mg iii. Diazepam: 2.5 mg iv. Fentanyl: 50 mcg v. Ibuprofen: 325 mg vi. Ketamine: 30 mg vii. Medcal: 2 mg viii. Morphine: 5 mg ix. Nitroglycerin: 0.4 mg c. Most Common Methods of Delivery (3 rd Quarter): MOD by Drug 00.00% 90.00% 80.00% 70.00% 60.00% 50.00% 40.00% 30.00% 20.00% 0.00% 0.00% 0.00% 97.87% Morphine Intramuscular Intravenous Intranasal 5.63% 84.38% Fentanyl
Medical Indicator Summary and Report Pain Management Cases - Nonpharmacological 3 Combination 3 5 9 6 Elevation Ice 4 Immobilization 55 Position of Comfort 28 SMR Splinting Stabilization Unspecified 2 Wound Care d. Total cases with non-pharmacological intervention: 54 i. Immobilization: 55 ii. Ice: 6 iii. Wound Care: 5 iv. Splinting: 28 v. Elevation: 3 vi. Position of Comfort: vii. Combination iv : 9 viii. Unspecified: 3 ix. Stabilization: 4 x. SMR: 2
Medical Indicator Summary and Report e. Total cases where intervention is unknown/unreported: 3 f. Total uses of pain scale: 363 g. Total number of cases with documented improvement: 82 Chart Title Percent with Pharmacological Intervention Percent Without 38 49 Trauma Medical Unclassified h. Number of cases classified trauma : 9 i. Trauma cases with pharmacological intervention: 73 i. Number of cases classified medical : 22 i. Medical cases with pharmacological intervention: 08 j. Number of unclassified cases: 2
Medical Indicator Summary and Report Summary of Outcomes Use of Pain Scale 363 Patient Improvement 82 Non-pharmacological Interventions 54 Pharamacological Interventions 8 Total Pain Management Cases 44 0 50 00 50 200 250 300 350 400 450
Medical Indicator Summary and Report i Only one agency specified method of delivery and dosage during quarter 2 on any medications administered, hence that data is excluded. Most common dosages were determined using data collected during 3 rd quarter. ii After developing these reports, I realized that some agencies listed oxygen as a non-pharmacological intervention. Therefore, the number of cases with pharmacological intervention was originally tallied as 69 during 2 nd quarter, then adjusted to accommodate those reports including oxygen. iii Generally combinations were ASA and Nitroglycerin. iv General combinations were ice and elevation, splinting and elevation, and immobilization and ice.
System Indicator Summary and Report Mechanical Aid Survey i : 3 2% 6 5% Mechanical Aids Inventory 23 7% 44 33% 58 43% CPAP Pacers Thumpers Portable Vent AED. Total number of reported mechanical aids: 34 a. CPAP: 58 b. Pacers (Cardiac Monitors): 44 c. Thumpers : 23 d. Portable Ventilators: 3 e. AEDs: 6 2. Number of agencies with each respective device (32 reporting): a. CPAP: 6 b. Pacers (Cardiac Monitors): 2 c. Thumpers : 8 d. Portable Ventilators: 3 e. AEDs:
System Indicator Summary and Report 3. Total number of calls during which a mechanical aid was used: 40 ALS, unspecified 0% AIC Level EMT-Basic 4% Enhanced 3% a. AIC Level: i. EMT-B: 34 ii. Enhanced: 3 iii. EMT-I: 45 iv. EMT-P: 5 v. ALS: 7 Paramedic 38% Intermediate 35% b. Type of call ii : i. Abdominal Pain - 3 ii. AMS - iii. Bowel Obstruction - iv. Cardiac - v. Cardiac Arrest - 33 vi. Chest Pain - 9 vii. CVA - 3 viii. Difficulty Breathing -22 ix. Medical, Uns. - 3 x. Nausea / Vomiting - xi. Pain, Unspecified - 2 xii. Pain, Other - xiii. Respiratory Distress - 2 xiv. Seizure - 4 xv. Syncope - xvi. Trauma, Fall - 3 xvii. Trauma, MVC - 2 xviii. Trauma, Uns. - 5 xix. Unresponsive - xx. Unspecified - 3
System Indicator Summary and Report Types of Calls with Mechanical Aid Usage 35 30 Cardiac Arrest 33 Medical, Uns. 3 25 20 5 Difficulty Breathing 22 Respiratory Distress 2 0 5 0 Abdominal Pain 3 AMS Bowel Obstruction 2 Cardiac Chest Pain 9 CVA 3 Nausea / Vomiting Pain, Unspecified 2 Type of Call Pain, Other Seizure 4 Syncope Trauma, Fall 3 Trauma, MVC 2 Trauma, Uns. 5 Unresponsive Unspecified 3
4. Device used, broken down by type of call: REMS Council Quality Improvement Committee System Indicator Summary and Report Pain - Other Unspecified Unresponsive Trauma Syncope Seizure Respiratory Distress Pain N/V MVC Medical Fall Difficulty Breathing CVA Chest Pain Cardiac Arrest Cardiac Bowel Obstruction AMS Abdominal Pain 0 2 4 6 8 0 2 4 6 8 20 Vacuum Splint Splint Suction Portable Vent ET Tube EZIO BVM Nebulizer ECG C-Collar Pacer Assisted CPR CPAP AED
System Indicator Summary and Report 5. AIC by Call Type iii : 20 20 8 6 4 2 0 9 9 8 6 0 8 6 4 2 0 8 7 6 4 0 0 3 0 0 0 0 0 ALS US 0 0 0 0 0 0 0 0 EMT-E 3 0 3 3 2 2 2 EMT-P 0 0 0 0 EMT-I 0 EMT-B Abdominal Pain Cardiac Arrest Chest Pain Difficulty Breathing Fall Medical Respiratory Distress Seizure Trauma EMT-B EMT-I EMT-P EMT-E ALS US
System Indicator Summary and Report 5. AIC by call type, continued (complete data): AIC by Call Type EMT-B EMT-I EMT-P EMT-E ALS US Abdominal Pain 2 - - - AMS - - - - Bowel Obstruction - - - Cardiac - - - - Cardiac Arrest 2 20 - - Chest Pain - 6 3 - - CVA 2 - - - Difficulty Breathing 2 0 9 - Fall 3 - - - - Medical 8 9 8-6 MVC 2 - - - - N/V - - - - Pain - - - Respiratory Distress 7 4 - - Seizure 3 - - - Syncope - - - - Trauma 3 - - Pain - Other - - - - Unresponsive - - - - Unspecified - - - 2-6. Improvement by device used: Percentage of Patients Improved 00% 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% Percentage of Patients Improved
System Indicator Summary and Report 8. Approximate Elapsed Time iv : a. Average Elapsed Time, in minutes: 6.67 b. Mode (time most often listed): 20 c. Median (middle of reported range): 5 d. Longest reported elapsed time: 36 i This data is the same data presented in the 2 nd quarter, as no additional information was received regarding which mechanical aids agencies posess. ii There were many different responses as far as Call Type goes. I believe that in the future, we should specify examples of what we mean by call type to prevent this wide range of responses. iii I left out call types which numbered less than 3 in order to enhance the readability of this diagram, and to include only the data which may provide a more accurate depiction of call assignments. See p. 7 for complete data set. iv This section includes data from Quarter 3 (January March, 205) only. 2 nd quarter data was inaccurate, with many agencies reporting the amount of time mechanical aid was used rather than elapsed time.
Trauma Indicator Data Analysis FY205 Quarters & 3 (July September, 204 & January March, 205). Total number of Trauma calls (both quarters):,564 2. Total number of burn patients from calls reviewed: 5 Trauma Calls 549 4 Unspecified Trauma Burns Heat Electrical Pain management not present in most reports (85%). Morphine administered to one patient, saline to another. Other reports do not specify. Of the 4 burns caused by heat, degree was listed in five (5) instances. Two (2) second degree burns; two (2) first degree burns; and one patient with second and third degree burns.