Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Settings and Patients
2.2. Data Collection
2.3. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Categories | Main Associated Terms |
---|---|
Motor vehicle collisions | Collision, run over, rollover, motorcycle, car, bus, bike, truck |
Death at scene (nontraumatic) | Death without assistance, death, sudden death |
Aggresion/stab wound/gunshot wound | Firearm, stab wound, aggression against women, aggression against elderly, sexual assault |
Other trauma | Building collapse, landslide, explosion, drowning, burn, electric shock |
Surgical emergencies | Acute abdominal pain, postoperative complication |
Cardiac emergencies | Syncope, chest pain, tachycardia, hypotension, hypertensive emergency |
Other medical emergencies | Pain, edema, epistaxis, hemorrhage, hyperglycemia, hypothermia, infection, eye complaints, neoplasm, hypoactivity, bleeding |
Respiratory emergencies | Respiratory failure, respiratory arrest, flu, suspected COVID-19, dyspnea, asthma, pneumonia, SARS |
Neurological emergencies | Facial asymmetry, coma, stroke, headache, paralysis, seizure, hemiplegia, hemiparesis, altered mental status |
Obstetric/gynecology emergencies | Miscarriage, amniorrhexis, eclampsia, preeclampsia, hyperemesis, out-of-hospital delivery, labor, vaginal bleeding |
Mental health emergencies | Psychomotor agitation, hallucination, delirium, psychosis, panic attack, suicide attempt, hanging, self-harm |
Intoxication | Alcohol, drugs, exogenous intoxication, toxic |
Occupational accident | Work-related accident |
Animal bites | Venomous animal accident, animal bite |
Total | Weeks 1–5 | Weeks 6–9 | Weeks 10–14 | Weeks 15–18 | Weeks 19–22 | Weeks 23–27 | p-Value | |
---|---|---|---|---|---|---|---|---|
n = 45,581 | n = 6016 | n = 5697 | n = 7333 | n = 12,600 | n = 7960 | n = 5975 | ||
Gender | 0.002 | |||||||
Female | 17,354/45,581 (38.1%) | 2233/6016 (37.1%) | 2056/5697 (36.1%) | 2785/7333 (38.0%) | 4876/12,600 (38.7%) | 3197/7960 (40.2%) | 2207/5975 (36.9%) | |
Male | 28,227/45,581 (61.9%) | 3783/6016 (62.9%) | 3641/5697 (63.9%) | 4548/7333 (62.0%) | 7724/12,600 (61.3%) | 4763/7960 (59.8%) | 3768/5975 (63.1%) | |
Age (years) | 47.0 (30.0–67.0) | 45.0 (28.0–67.0) | 44.0 (27.0–67.0) | 43.0 (26.0–64.0) | 52.0 (35.0–70.0) | 47.0 (30.0–67.0) | 43.0 (27.0–65.0) | <0.001 |
Dispatched unit | 0.82 | |||||||
Boat ambulance | 63/23,343 (0.3%) | 15/3909 (0.4%) | 7/3640 (0.2%) | 4/3274 (0.1%) | 17/4869 (0.3%) | 13/4093 (0.3%) | 7/3558 (0.2%) | |
Motorcycle ambulance | 69/23,343 (0.3%) | 15/3909 (0.4%) | 9/3640 (0.2%) | 33/3274 (1.0%) | 12/4869 (0.2%) | 0/4093 (0.0%) | 0/3558 (0.0%) | |
ALS ambulance | 2226/23,343 (9.5%) | 369/3909 (9.4%) | 304/3640 (8.4%) | 269/3274 (8.2%) | 586/4869 (12.0%) | 410/4093 (10.0%) | 288/3558 (8.1%) | |
BLS ambulance | 20,979/23,343 (89.9%) | 3510/3909 (89.8%) | 3318/3640 (91.2%) | 2966/3274 (90.6%) | 4254/4869 (87.4%) | 3669/4093 (89.6%) | 3262/3558 (91.7%) | |
Rapid intervention vehicle | 6/23,343 (0.0%) | 0/3909 (0.0%) | 2/3640 (0.1%) | 2/3274 (0.1%) | 0/4869 (0.0%) | 1/4093 (0.0%) | 1/3558 (0.0%) | |
Reason for EMS call | <0.001 | |||||||
Motor vehicle collisions | 3521/31,455 (11.2%) | 691/5114 (13.5%) | 759/4903 (15.5%) | 608/5385 (11.3%) | 262/5346 (4.9%) | 446/5612 (7.9%) | 755/5095 (14.8%) | |
Dead at scene | 616/31,455 (2.0%) | 105/5114 (2.1%) | 84/4903 (1.7%) | 77/5385 (1.4%) | 120/5346 (2.2%) | 142/5612 (2.5%) | 88/5095 (1.7%) | |
Aggression/SW/GSW | 1862/31,455 (5.9%) | 392/5114 (7.7%) | 364/4903 (7.4%) | 285/5385 (5.3%) | 170/5346 (3.2%) | 305/5612 (5.4%) | 346/5095 (6.8%) | |
Other Trauma | 2211/31,455 (7.0%) | 431/5114 (8.4%) | 479/4903 (9.8%) | 379/5385 (7.0%) | 207/5346 (3.9%) | 291/5612 (5.2%) | 424/5095 (8.3%) | |
Surgical | 343/31,455 (1.1%) | 75/5114 (1.5%) | 63/4903 (1.3%) | 39/5385 (0.7%) | 47/5346 (0.9%) | 54/5612 (1.0%) | 65/5095 (1.3%) | |
Cardiac emergencies | 2063/31,455 (6.6%) | 395/5114 (7.7%) | 359/4903 (7.3%) | 323/5385 (6.0%) | 268/5346 (5.0%) | 363/5612 (6.5%) | 355/5095 (7.0%) | |
Other medical emergencies * | 4505/31,455 (14.3%) | 582/5114 (11.4%) | 572/4903 (11.7%) | 840/5385 (15.6%) | 1171/5346 (21.9%) | 688/5612 (12.3%) | 652/5095 (12.8%) | |
Respiratory emergencies | 4935/31,455 (15.7%) | 447/5114 (8.7%) | 398/4903 (8.1%) | 709/5385 (13.2%) | 1335/5346 (25.0%) | 1464/5612 (26.1%) | 582/5095 (11.4%) | |
Neurological emergencies | 2611/31,455 (8.3%) | 472/5114 (9.2%) | 475/4903 (9.7%) | 458/5385 (8.5%) | 346/5346 (6.5%) | 380/5612 (6.8%) | 480/5095 (9.4%) | |
Gastrointestinal emergencies | 1669/31,455 (5.3%) | 299/5114 (5.8%) | 286/4903 (5.8%) | 279/5385 (5.2%) | 253/5346 (4.7%) | 262/5612 (4.7%) | 290/5095 (5.7%) | |
Ob/Gyn emergencies | 525/31,455 (1.7%) | 101/5114 (2.0%) | 105/4903 (2.1%) | 97/5385 (1.8%) | 51/5346 (1.0%) | 75/5612 (1.3%) | 96/5095 (1.9%) | |
Mental health emergencies | 1243/31,455 (4.0%) | 227/5114 (4.4%) | 255/4903 (5.2%) | 190/5385 (3.5%) | 136/5346 (2.5%) | 219/5612 (3.9%) | 216/5095 (4.2%) | |
Intoxication | 494/31,455 (1.6%) | 105/5114 (2.1%) | 110/4903 (2.2%) | 80/5385 (1.5%) | 31/5346 (0.6%) | 84/5612 (1.5%) | 84/5095 (1.6%) | |
Occupational accidents | 8/31,455 (0.0%) | 3/5114 (0.1%) | 1/4903 (0.0%) | 0/5385 (0.0%) | 0/5346 (0.0%) | 2/5612 (0.0%) | 2/5095 (0.0%) | |
Animal bites | 262/31,455 (0.8%) | 75/5114 (1.5%) | 62/4903 (1.3%) | 46/5385 (0.9%) | 19/5346 (0.4%) | 23/5612 (0.4%) | 37/5095 (0.7%) | |
Others | 4587/31,455 (14.6%) | 714/5114 (14.0%) | 531/4903 (10.8%) | 975/5385 (18.1%) | 930/5346 (17.4%) | 814/5612 (14.5%) | 623/5095 (12.2%) | |
Type of call | <0.001 | |||||||
External causes | 7929/34,979 (22.7%) | 1612/5714 (28.2%) | 1681/5415 (31.0%) | 1337/6006 (22.3%) | 651/6057 (10.7%) | 1083/6101 (17.8%) | 1565/5686 (27.5%) | |
Surgical | 125/34,979 (0.4%) | 15/5714 (0.3%) | 25/5415 (0.5%) | 16/6006 (0.3%) | 13/6057 (0.2%) | 17/6101 (0.3%) | 39/5686 (0.7%) | |
Medical | 19,540/34,979 (55.9%) | 2883/5714 (50.5%) | 2645/5415 (48.8%) | 3186/6006 (53.0%) | 4143/6057 (68.4%) | 3725/6101 (61.1%) | 2958/5686 (52.0%) | |
Ob/Gyn | 848/34,979 (2.4%) | 166/5714 (2.9%) | 163/5415 (3.0%) | 150/6006 (2.5%) | 96/6057 (1.6%) | 124/6101 (2.0%) | 149/5686 (2.6%) | |
Not evaluated | 4501/34,979 (12.9%) | 703/5714 (12.3%) | 522/5415 (9.6%) | 952/6006 (15.9%) | 918/6057 (15.2%) | 799/6101 (13.1%) | 607/5686 (10.7%) | |
Pediatrics | 705/34,979 (2.0%) | 82/5714 (1.4%) | 107/5415 (2.0%) | 160/6006 (2.7%) | 100/6057 (1.7%) | 124/6101 (2.0%) | 132/5686 (2.3%) | |
Mental health | 1331/34,979 (3.8%) | 253/5714 (4.4%) | 272/5415 (5.0%) | 205/6006 (3.4%) | 136/6057 (2.2%) | 229/6101 (3.8%) | 236/5686 (4.2%) | |
Response time (minutes) | 35.0 (24.0–54.6) | 32.8 (21.8–48.1) | 32.8 (21.8–48.1) | 32.8 (21.8–48.1) | 45.9 (30.6–67.7) | 43.7 (28.4–63.4) | 35.0 (24.0–50.2) | <0.001 |
City zones | 0.88 | |||||||
West central | 2423/33,670 (7.2%) | 390/5455 (7.1%) | 361/5208 (6.9%) | 406/5789 (7.0%) | 407/5866 (6.9%) | 448/5896 (7.6%) | 411/5456 (7.5%) | |
South central | 2945/33,670 (8.7%) | 470/5455 (8.6%) | 509/5208 (9.8%) | 587/5789 (10.1%) | 474/5866 (8.1%) | 435/5896 (7.4%) | 470/5456 (8.6%) | |
East | 7498/33,670 (22.3%) | 1249/5455 (22.9%) | 1096/5208 (21.0%) | 1321/5789 (22.8%) | 1325/5866 (22.6%) | 1332/5896 (22.6%) | 1175/5456 (21.5%) | |
North | 9706/33,670 (28.8%) | 1578/5455 (28.9%) | 1487/5208 (28.6%) | 1596/5789 (27.6%) | 1647/5866 (28.1%) | 1786/5896 (30.3%) | 1612/5456 (29.5%) | |
West | 4544/33,670 (13.5%) | 681/5455 (12.5%) | 673/5208 (12.9%) | 755/5789 (13.0%) | 849/5866 (14.5%) | 833/5896 (14.1%) | 753/5456 (13.8%) | |
South | 6385/33,670 (19.0%) | 1068/5455 (19.6%) | 1068/5208 (20.5%) | 1101/5789 (19.0%) | 1135/5866 (19.3%) | 1017/5896 (17.2%) | 996/5456 (18.3%) | |
Riverine communities | 169/33,670 (0.5%) | 19/5455 (0.3%) | 14/5208 (0.3%) | 23/5789 (0.4%) | 29/5866 (0.5%) | 45/5896 (0.8%) | 39/5456 (0.7%) |
Total | Pre-Pandemic | Pandemic | p-Value | |
---|---|---|---|---|
n = 45,581 | n = 14,133 | n = 31,448 | ||
Age (years) | 47.0 (30.0–67.0) | 44.0 (27.0–66.0) | 48.0 (30.0–68.0) | <0.001 |
Dispatched unit | 0.0007 | |||
Boat ambulance | 63/23,343 (0.3%) | 25/8888 (0.3%) | 38/14,455 (0.3%) | |
Motorcycle ambulance | 69/23,343 (0.3%) | 34/8888 (0.4%) | 35/14,455 (0.2%) | |
ALS ambulance | 2226/23,343 (9.5%) | 762/8888 (8.6%) | 1464/14,455 (10.1%) | |
BLS ambulance | 20,979/23,343 (89.9%) | 8064/8888 (90.7%) | 12,915/14,455 (89.3%) | |
Rapid intervention vehicle | 6/23,343 (0.0%) | 3/8888 (0.0%) | 3/14,455 (0.0%) | |
Reason for EMS call | <0.001 | |||
Motor vehicle collision | 3521/31,455 (11.2%) | 1770/11,887 (14.9%) | 1751/19,568 (8.9%) | |
Death at scene (non-traumatic) | 616/31,455 (2.0%) | 208/11,887 (1.7%) | 408/19,568 (2.1%) | |
Physical aggression/GSW/SW | 1862/31,455 (5.9%) | 867/11,887 (7.3%) | 995/19,568 (5.1%) | |
Other traumatic emergencies | 2211/31,455 (7.0%) | 1055/11,887 (8.9%) | 1156/19,568 (5.9%) | |
Surgical emergencies | 343/31,455 (1.1%) | 152/11,887 (1.3%) | 191/19,568 (1.0%) | |
Cardiac emergencies | 2063/31,455 (6.6%) | 878/11,887 (7.4%) | 1185/19,568 (6.1%) | |
Other medical emergencies | 4505/31,455 (14.3%) | 1356/11,887 (11.4%) | 3149/19,568 (16.1%) | |
Respiratory emergencies | 4935/31,455 (15.7%) | 991/11,887 (8.3%) | 3944/19,568 (20.2%) | |
Neurological emergencies | 2611/31,455 (8.3%) | 1138/11,887 (9.6%) | 1473/19,568 (7.5%) | |
Gastrointestinal emergencies | 1669/31,455 (5.3%) | 689/11,887 (5.8%) | 980/19,568 (5.0%) | |
Ob/Gyn emergencies | 525/31,455 (1.7%) | 248/11,887 (2.1%) | 277/19,568 (1.4%) | |
Mental health emergencies | 1243/31,455 (4.0%) | 559/11,887 (4.7%) | 684/19,568 (3.5%) | |
Intoxication | 494/31,455 (1.6%) | 255/11,887 (2.1%) | 239/19,568 (1.2%) | |
Occupational accidents | 8/31,455 (0.0%) | 4/11,887 (0.0%) | 4/19,568 (0.0%) | |
Animal bites | 262/31,455 (0.8%) | 149/11,887 (1.3%) | 113/19,568 (0.6%) | |
Others | 4587/31,455 (14.6%) | 1568/11,887 (13.2%) | 3019/19,568 (15.4%) | |
Type of call | <0.001 | |||
External cause | 7929/34,979 (22.7%) | 3892/13,197 (29.5%) | 4037/21,782 (18.5%) | |
Surgical | 125/34,979 (0.4%) | 46/13,197 (0.3%) | 79/21,782 (0.4%) | |
Medical | 19,540/34,979 (55.9%) | 6497/13,197 (49.2%) | 13,043/21,782 (59.9%) | |
Ob/Gyn | 848/34,979 (2.4%) | 392/13,197 (3.0%) | 456/21,782 (2.1%) | |
Not evaluated | 4501/34,979 (12.9%) | 1534/13,197 (11.6%) | 2967/21,782 (13.6%) | |
Pediatrics | 705/34,979 (2.0%) | 231/13,197 (1.8%) | 474/21,782 (2.2%) | |
Mental health | 1331/34,979 (3.8%) | 605/13,197 (4.6%) | 726/21,782 (3.3%) | |
Response time (minutes) | 35.0 (24.0–54.6) | 32.8 (21.8–48.1) | 39.3 (26.2–59.0) | <0.001 |
City zones | 0.80 | |||
West central | 2423/33,670 (7.2%) | 889/12,637 (7.0%) | 1534/21,033 (7.3%) | |
South central | 2945/33,670 (8.7%) | 1170/12,637 (9.3%) | 1775/21,033 (8.4%) | |
East | 7498/33,670 (22.3%) | 2784/12,637 (22.0%) | 4714/21,033 (22.4%) | |
North | 9706/33,670 (28.8%) | 3632/12,637 (28.7%) | 6074/21,033 (28.9%) | |
West | 4544/33,670 (13.5%) | 1594/12,637 (12.6%) | 2950/21,033 (14.0%) | |
South | 6385/33,670 (19.0%) | 2522/12,637 (20.0%) | 3863/21,033 (18.4%) | |
Riverine communities | 169/33,670 (0.5%) | 46/12,637 (0.4%) | 123/21,033 (0.6%) |
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Fernandes, E.; Silva, B.M.d.; Goulart, C.d.L.; Valente, J.; Cubas-Vega, N.; Sato, C.; Rezende, A.G.; Almeida, T.V.R.; de Amorim, R.L.O.; Salinas, J.L.; et al. Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19. Int. J. Environ. Res. Public Health 2024, 21, 1229. https://doi.org/10.3390/ijerph21091229
Fernandes E, Silva BMd, Goulart CdL, Valente J, Cubas-Vega N, Sato C, Rezende AG, Almeida TVR, de Amorim RLO, Salinas JL, et al. Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19. International Journal of Environmental Research and Public Health. 2024; 21(9):1229. https://doi.org/10.3390/ijerph21091229
Chicago/Turabian StyleFernandes, Eduardo, Bernardo Maia da Silva, Cássia da Luz Goulart, Jefferson Valente, Nádia Cubas-Vega, Camila Sato, Anna Gabriela Rezende, Taynna Vernalha Rocha Almeida, Robson Luís Oliveira de Amorim, Jorge Luis Salinas, and et al. 2024. "Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19" International Journal of Environmental Research and Public Health 21, no. 9: 1229. https://doi.org/10.3390/ijerph21091229
APA StyleFernandes, E., Silva, B. M. d., Goulart, C. d. L., Valente, J., Cubas-Vega, N., Sato, C., Rezende, A. G., Almeida, T. V. R., de Amorim, R. L. O., Salinas, J. L., Monteiro, W. M., Arêas, G. P. T., & Almeida-Val, F. (2024). Exploring Prehospital Data for Pandemic Preparedness: A Western Brazilian Amazon Case Study on COVID-19. International Journal of Environmental Research and Public Health, 21(9), 1229. https://doi.org/10.3390/ijerph21091229