Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study

Melanie Villani, Natalie Nanayakkara, Sanjeeva Ranasinha, Arul Earnest, Karen Smith, Georgia Soldatos, Helena Teede, Sophia Zoungas

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    Abstract

    Aims: This study examines prehospital Emergency Medical Service (EMS) utilisation and patterns of demand for hyperglycaemia management, including characteristics of individuals and factors related to hospital transport. Materials and methods: A state-wide, community-based observational study of all patients requiring prehospital EMS for hyperglycaemia during a 7 year study period (Jan 2009–Dec 2015) using electronic data from the Ambulance Victoria data warehouse was conducted. Pre-specified variables related to patient demographics, comorbidities, examination findings, paramedic treatment and transport outcomes were obtained. Logistic regression was used to assess factors associated with transport to hospital. Results: There were 11,417 cases of hyperglycaemia attended by paramedics during the study period, accounting for 0.3–0.4% of the total annual EMS caseload, and equating to 0.54 attendances per 100 people with diabetes in the state of Victoria, Australia, per year. There was a significant increase in annual utilisation, with a rate ratio of 1.62 between 2009 (2.42 cases per 10,000 population) and 2015 (3.91 cases per 10,000 population). Fifty-one percent of cases had type 2 diabetes, 37% had type 1 diabetes, 4% had diabetes with the type unspecified and 8% had no recorded history of diabetes. Ninety percent of cases were transported to hospital. Factors associated with increased odds of transport to hospital included no known history of diabetes, regional/rural locations, case time between 0600 and <1800 hours, increasing number of comorbidities and increasingly unstable vital sign observations. Conclusion: There is substantial utilisation of prehospital EMS for hyperglycaemia. With increased population prevalence of diabetes predicted, further research on opportunities for prevention, as well as optimal management in the prehospital environment is warranted.

    LanguageEnglish
    Article numbere0182413
    Number of pages12
    JournalPLoS ONE
    Volume12
    Issue number8
    DOIs
    StatePublished - 1 Aug 2017

    Fingerprint

    Emergency Medical Services
    observational studies
    hyperglycemia
    Medical problems
    Hyperglycemia
    Observational Studies
    diabetes
    allied health professionals
    Allied Health Personnel
    Victoria (Australia)
    Victoria
    Comorbidity
    Population
    Ambulances
    Vital Signs
    Type 1 Diabetes Mellitus
    Type 2 Diabetes Mellitus
    insulin-dependent diabetes mellitus
    noninsulin-dependent diabetes mellitus
    Logistic Models

    Cite this

    Villani, M., Nanayakkara, N., Ranasinha, S., Earnest, A., Smith, K., Soldatos, G., ... Zoungas, S. (2017). Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study. PLoS ONE, 12(8), [e0182413]. DOI: 10.1371/journal.pone.0182413
    Villani, Melanie ; Nanayakkara, Natalie ; Ranasinha, Sanjeeva ; Earnest, Arul ; Smith, Karen ; Soldatos, Georgia ; Teede, Helena ; Zoungas, Sophia. / Utilisation of prehospital emergency medical services for hyperglycaemia : A community-based observational study. In: PLoS ONE. 2017 ; Vol. 12, No. 8.
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    Villani, M, Nanayakkara, N, Ranasinha, S, Earnest, A, Smith, K, Soldatos, G, Teede, H & Zoungas, S 2017, 'Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study' PLoS ONE, vol 12, no. 8, e0182413. DOI: 10.1371/journal.pone.0182413

    Utilisation of prehospital emergency medical services for hyperglycaemia : A community-based observational study. / Villani, Melanie; Nanayakkara, Natalie; Ranasinha, Sanjeeva; Earnest, Arul; Smith, Karen; Soldatos, Georgia; Teede, Helena; Zoungas, Sophia.

    In: PLoS ONE, Vol. 12, No. 8, e0182413, 01.08.2017.

    Research output: Contribution to journalArticle

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    AU - Ranasinha,Sanjeeva

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    Villani M, Nanayakkara N, Ranasinha S, Earnest A, Smith K, Soldatos G et al. Utilisation of prehospital emergency medical services for hyperglycaemia: A community-based observational study. PLoS ONE. 2017 Aug 1;12(8). e0182413. Available from, DOI: 10.1371/journal.pone.0182413