Feasibility of Partnering with Emergency Medical Services to Identify People at Risk for Uncontrolled High Blood Pressure

Abstract

IntroductionUncontrolled high blood pressure (HBP) is a significant health problem and often goes undetected. In the prehospital care-delivery system of 9-1-1 emergency medical services (EMS) calls, emergency medical technicians (EMTs) routinely collect medical information, including blood pressure values, that may indicate the presence of chronic disease. This information is usually archived without any further follow-up. We conducted several planning activities during the fall of 2006 to determine if a partnership between researchers at the Health Marketing Research Center at the University of Washington, Public Health Seattle King County EMS division, and several large fire departments could be developed to help identify community residents with uncontrolled HBP and determine the most effective way to communicate HBP information to them.MethodsWe partnered with 4 King County, Washington, fire departments that provide 9-1-1 EMS to develop an intervention for people with uncontrolled HBP who were attended by EMTs in response to a 9-1-1 call for assistance. On the basis of discussions with EMS personnel at all levels, we developed a system by which we could identify at-risk community residents by using medical incident report forms that EMS personnel completed; we consulted with EMS personnel to determine the most effective means of reaching these people. In addition we developed a survey to assess community residents' beliefs about blood pressure control, the role of EMTs as health care providers, and the convenience of fire stations as places to have blood pressure checked. Using contact information that EMS personnel obtained, we surveyed 282 community residents from a total of 794 people whom EMTs had identified as at risk for uncontrolled HBP to help us understand our target audience.ResultsIn consultation with EMS personnel, we determined that direct mail was the most effective way to reach people with uncontrolled HBP identified from EMS records to advise them of their risk. On the basis of the number with a known response to each question, 67% (n = 180/269) of the respondents reported that a doctor or other health professional had told them they had HBP, 95% (246/259) believed that regular screening for HBP was important, 65% (166/254) said that EMTs were highly credible health care providers, and 82% (136/165) said that they would feel comfortable receiving blood pressure screening at a local fire station.ConclusionPartnering with local EMS may be an effective way to identify and reach community residents with uncontrolled HBP with information on their medical condition and to encourage them to have follow-up screening.

Analysis of the Interventions of Medical Emergency Teams in Older Patients in Selected Polish Cities with County Status: A Retrospective Cohort Study

“…Only a more extensive diagnostic work-up in a hospital allows for a more detailed diagnosis. It should be noted here that an incorrect diagnosis does not result from the lack of knowledge or skills on the part of the emergency medical personnel, but only from the limited possibilities of pre-hospital care [26].…”

Factors Associated With the Adoption of a Patient Education Intervention Among First Responders, King County, Washington, 2010–2011

“…Although age was not significantly associated with use of the MIRF backer, junior firefighter EMTs reported greater use of the MIRF backer. The fire departments in King County have participated in many other patient outreach programs over the years ( 11 , 15 , 16 ), and enthusiasm for new programs may wane over time. Alternatively, newly trained first responders may be more open to new approaches to patient care because they might not have firmly established habits.…”

“…Previous research shows that EMS-delivered chronic disease education can affect knowledge and behavior ( 11 , 12 , 16 ), but monetary costs of such interventions are high. Our study shows that a brief at-scene intervention in combination with patient materials is feasible.…”