Morbidity and Mortality Associated with Prehospital “Lift-assist” Calls

Abstract

LA calls are associated with short-term morbidity and mortality. Patient age was found to be associated with these outcomes. These calls may be early indicators of problems requiring comprehensive medical evaluation and thus further factors associated with poor outcomes should be determined.

Ten years of EMS Fall Calls in a Community: An Opportunity for Injury Prevention Strategies

“…6 In addition, lift-assist calls are associated with increased morbidity and mortality within 14 days of a lift-assist call. 7 Emerging evidence indicates that the “lift assist” call should be considered a sentinel event and perhaps serve as a trigger for additional assessment and intervention to prevent injury, medical deterioration, and disability to older patients within a community. 8 …”

Researching Lift-Assists: Nebulous Complexity

“…2 In Dr. Leggatt's study, 14% percent of the ambulance call reports for lift-assist patients were missing at least one vital sign-primarily temperatureand more than a quarter of patients with a history of diabetes did not have a documented blood glucose level. 1 One interpretation of this finding is that many patients were inadequately assessed, with the presumption that better assessment might have identified patients at risk and prevented some of the subsequent ED visits, hospitalizations and/or deaths. Another possibility is that some patients simply refused detailed assessment once the lift-assist was complete.…”

“…In both studies, approximately one in five lift-assist patients had a subsequent ED visit, 1,2 and this newest study reported one in eight lift-assist patients were subsequently hospitalized. 1 What we don't know is how the rates of repeat EMS calls, ED visits and hospitalizations in the lift-assist population compare to those of simple fall patients who are transported to hospital, or to those of other non-transport patients, or to those of the elderly population in general. In the absence of a randomized controlled trial in which lift-assist patients are allocated to transport and non-transport cohorts, what is the most appropriate comparison group for evaluating outcomes of lift-assist patients?…”

“…Lawrence H. Brown, PhD, MPH&TM PREHOSPITAL EMERGENCY CARE 2017;21:670-672 In this issue of Prehospital Emergency Care, Leggatt et al 1 describe patient morbidity and mortality following lift-assist calls in London, Ontario. Within 14 days of an initial lift-assist call, 21% of patients had a subsequent emergency department (ED) visit; nearly 12% required hospital admission; and 1% died.…”

“…Leggatt and her colleagues defined a lift-assist call as when an " …individual is assisted up to a more mobile position from the ground by paramedics, but not treated or brought to hospital for further medical attention." 1 Although not explicitly stated, " …from the ground …" suggests these were largely simple falls. In contrast, Cone et al 2 used a broader definition, including patients who " …are unable to move from an undesirable position to a preferred one …."…”