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首页> 外文期刊>Prehospital emergency care >Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing
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Multiple Naloxone Administrations Among Emergency Medical Service Providers is Increasing

机译：紧急医疗服务提供者之间的多个纳洛酮管理局正在增加

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Background: Opioid overdoses are at epidemic levels in the United States. Emergency Medical Service (EMS) providers may administer naloxone to restore patient breathing and prevent respiratory arrest. There was a need for contemporary data to examine the number of naloxone administrations in an EMS encounter. Methods: Using data from the National Emergency Medical Services Information System, we examined data from 2012-5 to determine trends in patients receiving multiple naloxone administrations (MNAs). Logistic regression including demographic, clinical, and operational information was used to examine factors associated with MNA. Results: Among all events where naloxone was administered only 16.7% of the 911 calls specifically identified the medical emergency as a drug ingestion or poisoning event. The percentage of patients receiving MNA increased from 14.5% in 2012 to 18.2% in 2015, which represents a 26% increase in MNA in 4years. Patients aged 20-29 had the highest percentage of MNA (21.1%). Patients in the Northeast and the Midwest had the highest relative MNA (Chi Squared = 539.5, p < 0.01 and Chi Squared = 351.2, p < 0.01, respectively). The logistic regression model showed that the adjusted odds ratios (aOR) for MNA were greatest among people who live in the Northeast (aOR = 1.18, 95% CI = 1.13-1.22) and for men (aOR = 1.13, 95% CI = 1.10-1.16), but lower for suburban and rural areas (aOR = 0.76, 95% CI = 0.72-0.80 and aOR = 0.85, 95% CI = 0.80-0.89) and lowest for wilderness areas (aOR = 0.76, 95% CI = 0.68-0.84). Higher adjusted odds of MNA occurred when an advanced life support (ALS 2) level of service was provided compared to basic life support (BLS) ambulances (aOR = 2.15, 95% CI = 1.45-3.16) and when the dispatch complaint indicated there was a drug poisoning event (aOR = 1.12, 95% CI = 1.09-1.16). Reported layperson naloxone administration prior to EMS arrival was rare (1%). Conclusion: This study shows that frequency of MNA is growing over time and is regionally dependent. MNA may be a barometer of the potency of the opioid involved in the overdose. The increase in MNA provides support for a dosage review. Better identification of opioid related events in the dispatch system could lead to a better match of services with patient needs.
机译：背景：阿片类药物过量在美国的疫情水平。紧急医疗服务（EMS）提供商可以施用纳洛酮以恢复患者呼吸并防止呼吸逮捕。当代数据需要检查EMS遇到的纳洛酮管理的数量。方法：使用国家紧急医疗服务信息系统的数据，我们从2012-5中检查了数据，以确定接受多种纳洛酮施用的患者的趋势（MNA）。 Logistic回归包括人口统计学，临床和操作信息，用于检查与MNA相关的因素。结果：在纳洛酮施用的所有事件中，只有911个呼叫中的16.7％，特别认为医疗紧急情况是药物摄取或中毒事件。接受MNA的患者的百分比从2012年的14.5％增加到2015年的18.2％，而4年的MNA增加26％。 20-29岁的患者的MNA百分比最高（21.1％）。在东北部和中西部的患者具有最高的相对MNA（Chi Squared = 539.5，P <0.01和Chi平方分别分别为351.2，P <0.01）。 Logistic回归模型表明，在居住在东北部的人（AOR = 1.18,95％CI = 1.13-1.22）和男性（AOR = 1.13,95％CI = 1.10）中，MNA的调整后比率（AOR）是最伟大的-1.16），但郊区和农村地区的降低（AOR = 0.76,95％CI = 0.72-0.80和AOR = 0.85,95％CI = 0.80-0.89）和最低用于荒野区域（AOR = 0.76,95％CI = 0.68-0.84）。与基本寿命支持（BLS）救护车（AOR = 2.15,95％CI = 1.45-3.16）进行先进的寿命支持（ALS 2）服务水平时，发生了较高的MNA的MNA的几率。（AOR = 2.15,95％CI = 1.45-3.16）。药物中毒事件（AOR = 1.12,95％CI = 1.09-16）。报告EMS到达之前的Layperson Naloxone给药罕见（1％）。结论：本研究表明，MNA的频率随着时间的推移而越来越多，并且是区域依赖性的。 MNA可能是涉及过量的阿片类药物效力的晴雨表。 MNA的增加提供了对剂量审查的支持。更好地识别调度系统中的表阿片相关事件可能导致患者需求的服务更好。

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