Risk factors for cancellation after dispatch of rapid response cars for prehospital emergency care: a single-center, case-control study.

AIM: The objective of this study is to identify the risk factors for cancellation after dispatch of rapid response cars (RRC) for prehospital emergency care. METHODS: We retrospectively extracted data from all RRC cases dispatched from our hospital between April 2017 and March 2019. A total of 1,440 cases were included in our study and divided into either the "cancelled" group (n = 723) or the "treated" group (n = 717), based on the occurrence of cancellation. The variables obtained from the request calls for RRC included patient characteristics, distance from the hospital to the scene, and reasons for RRC request. The variables were compared between the two groups and logistic regression analysis was carried out to identify the risk factors for RRC cancellation. RESULTS: Multivariable analysis showed that distance from the hospital to the scene (odds ratio [OR] 1.25; 95% confidence interval (CI), 1.21-1.28), suspicion of cardiopulmonary arrest with no witness information (OR 7.61; 95% CI, 4.13-14.00), dyspnea (OR 2.22; 95% CI, 1.19-4.11), and suicide by hanging (OR 3.49; 95% CI, 1.37-8.89) were independent risk factors for cancellation. CONCLUSIONS: In our study, a greater distance from the hospital to the scene, suspicion of cardiopulmonary arrest with no witness information, dyspnea, and suicide by hanging were identified as independent risk factors for cancellation after dispatch of RRC. Evaluating the risk factors for cancellation at individual facilities could help hospitals adjust their dispatch criteria to allocate limited medical resources more effectively.

Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs.

Electrical injuries induce ventricular arrhythmias, which are lethal. Therefore, it is important to evaluate the risk of arrhythmias at initial presentation to the emergency department in cases of electrical injuries. Here, we report two cases with electrical injuries, where current flowed between the upper limbs, requiring 24-h hospitalization for arrhythmia monitoring. The patients were 57- and 30-year-old men, who sustained separate electrical injuries (6600 V, line voltage), with current flow from one hand to the other. They did not develop any ventricular arrhythmias during hospitalization and were discharged. The risk for ventricular arrhythmias is lower for electrical injuries occurring between the upper limbs than for those occurring between the upper and lower limbs. We conclude that 24-h hospitalization for monitoring of patients with electrical injuries of the upper limbs may be sufficient.