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Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

  • Mazen El Sayed (a1) (a2), Hani Tamim (a3) and N. Clay Mann (a4)
Abstract
Background

Emergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs).

Objectives

This study describes prehospital medication administration during MCIs by different EMS service levels.

Methods

The US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out.

Results

Among the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (P<.01) except for “Analgesia (other)” (P=.40) and “Pain medications (nonsteroidal anti-inflammatory drug; NSAID)” (P=.07).

Conclusion

Medications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.

El Sayed M , Tamim H , Mann NC . Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States. Prehosp Disaster Med. 2016;31(2):141149.

Copyright
Corresponding author
Correspondence: Mazen J. El Sayed, MD, MPH, FAAEM, FACEP Department of Emergency Medicine American University of Beirut Medical Center P.O. Box - 11-0236 Riad El Solh Beirut 1107 2020 Email: melsayed@aub.edu.lb
References
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1. Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response. Strategic National Stockpile (SNS). Centers for Disease Control and Prevention Web site. http://www.cdc.gov/phpr/stockpile/stockpile.htm. Published July 10, 2014. Accessed February 9, 2015.
2. Koenig, KL, Lim, H, Tsai, SH. Crisis standard of care: refocusing health care goals during catastrophic disasters and emergencies. J Exp Clin Med. 2011;3(4):159-165.
3. Erich, J. Drug shortages: your 20 step guide to survival. Medication shortages are the new normal—here’s how to manage long-term. EMS World. 2012;41(6):26-32.
4. EMS service providers struggle with shortages of key, life-saving drugs. ED Manag. 2011;23(12):136-137.
5. Schenk, E, Wijetunge, G, Mann, NC, Lerner, EB, Longthorne, A, Dawson, D. Epidemiology of mass-casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416.
6. Dawson, DE. National Emergency Medical Services Information System. Prehosp Emerg Care. 2006;10(3):314-316.
7. Mann, NC, Kane, L, Dai, M, Jacobson, K. Description of the 2012 NEMSIS Public-Release Research Dataset. Prehosp Emerg Care. 2015;19(2):232-240.
8. National Emergency Medical Services Information System. NEMSIS Data Dictionary V 2.2.1. www.nemsis.org/v2/downloads/documents/NEMSIS Data Dictionary v2.2.1 04092012.pdf. Accessed September 8, 2014.
9. Centers for Medicare & Medicaid Services (CMS) Manual. Definition of ambulance services. http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R130BP.pdf. Accessed October 1, 2014.
10. Sporer, KA, Wilson, KG. How well do emergency medical dispatch codes predict prehospital medication administration in a diverse urban community? J Emerg Med. 2013;44(2):413-422.
11. Ritz, RH, Previtera, JE. Oxygen supplies during a mass-casualty situation. Respir Care. 2008;53(2):215-224.
12. Blakeman, TC, Branson, RD. Oxygen supplies in disaster management. Respir Care. 2013;58(1):173-183.
13. Thomas, SH, Brown, KM, Oliver, ZJ, et al. An Evidence-based guideline for the air medical transportation of prehospital trauma patients. Prehosp Emerg Care. 2014;18(Suppl 1):35-44.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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