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At-risk patient documentation and naloxone dispersal for a rural statewide EMS "Naloxone Leave Behind" program.
Naumann, Jesse; Benson, Jamie; Lamberson, Miles; Hunt, Samantha; Moran, William; Stevens, Martha W; Wolfson, Daniel.
Afiliación
  • Naumann J; Department of Emergency Medicine Larner College of Medicine, University of Vermont Burlington Vermont USA.
  • Benson J; Department of Radiology University of Vermont Burlington Vermont USA.
  • Lamberson M; Division of Acute Care Surgery Department of Surgery University of Vermont Burlington Vermont USA.
  • Hunt S; Department of Emergency Medicine Larner College of Medicine, University of Vermont Burlington Vermont USA.
  • Moran W; Department of Emergency Medicine Larner College of Medicine, University of Vermont Burlington Vermont USA.
  • Stevens MW; Department of Emergency Medicine Dartmouth Health Burlington Vermont USA.
  • Wolfson D; Division of Emergency Preparedness Response, and Injury Prevention Vermont Department of Health Burlington Vermont USA.
J Am Coll Emerg Physicians Open ; 5(3): e13186, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38766594
ABSTRACT

Objectives:

For successful Naloxone Leave Behind (NLB) programs, Emergency Medical Services (EMS) must identify patients at-risk for opioid overdose. We describe the first year of Vermont's NLB program and report rates of EMS documentation of at-risk patients with subsequent distribution of NLB kits in the subgroup of those refusing transport to an emergency department (ED).

Methods:

This retrospective cohort review of all EMS encounters over 1 year compared on-scene EMS documented to retrospective chart reviewidentified at-risk patients eligible for NLB kit dispersal. EMS was educated to identify at-risk patients through statewide mandatory training modules. At-risk patients were identified by electronic chart review using the same training criteria. As per protocol, patients identified as at-risk by EMS who refuse ED transport are eligible for NLB. NLB-appropriate patients by retrospective chart review without NLB protocol use documentation by EMS were considered "missed."

Results:

Of 110,701 EMS encounters, 2507 (2.4%) were at-risk by chart review. Among these, 793 refused transport to an ED. In this chart-review at-risk non-transported group, EMS documented 407 (51.3%) patients as at-risk by documenting use of the NLB protocol. Of these 407, EMS provided 141 (34.6%) with NLB kits. Fifteen (3.7%) patients refused kits. There were 386 (48.7%) potentially "missed" opportunities for NLB dispersal.

Conclusion:

EMS documented 51.3% of patients eligible for NLB dispersal, with 34.6% receiving kits. There was no documentation for 48.7% of chart-review at-risk patients, suggesting "missed" distribution opportunities. This study highlights the need for improved EMS identification of at-risk patients, EMS documentation adherence, and NLB kit provision.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Coll Emerg Physicians Open Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Am Coll Emerg Physicians Open Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos