Patient and paramedic call characteristics (January 2008–June 2014), stratified by refusal of transport
| Characteristic | No. (%) of calls* | p value‡ | ||
|---|---|---|---|---|
| Total | Transport refusal | No refusal of transport† | ||
| Calls | 9185 | 2243 (24.4) | 6942 (75.6) | |
| Patient characteristics | ||||
| Age, yr, mean ± SD (n = 9162) | 60.2 ± 19.0 | 58.6 ± 19.7 | 60.8 ± 18.7 | < 0.001 |
| Sex, male (n = 9146) | 5197 (56.8) | 1333/2236 (59.6) | 3864/6910 (55.9) | 0.002 |
| Documented diabetes diagnosis | 7450 (81.1) | 1746 (77.8) | 5704 (82.2) | < 0.001 |
| Insulin use | 3883 (42.3) | 963 (42.9) | 2920 (42.1) | 0.5 |
| Oral antihyperglycemic agent use | 1441 (15.7) | 316 (14.1) | 1125 (16.2) | 0.02 |
| Capillary blood glucose on paramedic arrival, mmol/L, mean ± SD (n = 9026) | 2.5 ± 1.0 | 3.2 ± 1.1 | 2.3 ± 0.9 | < 0.001 |
| Capillary blood glucose on paramedic arrival < 2.5 mmol/L (n = 9026) | 4931 (54.6) | 504/2149 (23.5) | 4427/6877 (64.4) | < 0.001 |
| Initial Glasgow Coma Scale score < 9 (n = 9019) | 2181 (24.2) | 385/2190 (17.6) | 1796/6829 (26.3) | < 0.001 |
| Call characteristics | ||||
| Canadian Triage Acuity Scale level ≤ 3 (n = 7731) | 7383 (95.5) | 1561/1703 (91.7) | 5822/6028 (96.6) | < 0.001 |
| Time of calls (n = 9092) | 0.007 | |||
| 00:00–05:59 | 1860 (20.5) | 502/2222 (22.6) | 1358/6870 (19.8) | |
| 06:00–11:59 | 2084 (22.9) | 493/2222 (22.2) | 1591/6870 (23.2) | |
| 12:00–17:59 | 2706 (29.8) | 615/2222 (27.7) | 2091/6870 (30.4) | |
| 18:00–23:59 | 2442 (26.9) | 612/2222 (27.5) | 1830/6870 (26.6) | |
| Type of crew§ (n = 9168) | 0.2 | |||
| Emergency medical assistants | 2 (0.02) | 1/2237 (0.04) | 1/6931 (0.01) | |
| Primary care paramedics | 6717 (73.3) | 1657/2237 (74.1) | 5060/6931 (73.0) | |
| Primary care paramedics with advanced training to administer IV medications | 159 (1.7) | 29/2237 (1.3) | 130/6931 (1.9) | |
| Advanced care paramedics | 2290 (25.0) | 550/2237 (24.6) | 1740/6931 (25.1) | |
| Treatment | < 0.001 | |||
| Oral glucose alone | 2072 (22.6) | 871 (38.8) | 1201 (17.3) | |
| IV dextrose alone | 3189 (34.7) | 656 (29.2) | 2533 (36.5) | |
| IM glucagon alone | 1679 (18.3) | 339 (15.1) | 1340 (19.3) | |
| Oral glucose and IV dextrose | 534 (5.8) | 84 (3.7) | 450 (6.5) | |
| Oral glucose and IM glucagon | 1501 (16.3) | 264 (11.8) | 1237 (17.8) | |
| IV dextrose and IM glucagon | 186 (2.0) | 24 (1.1) | 162 (2.3) | |
| Oral glucose, IV dextrose and IM glucagon | 24 (0.3) | 5 (0.2) | 19 (0.3) | |
| Treatment (not mutually exclusive¶) | ||||
| Oral glucose | 4131 (45.0) | 1224 (54.6) | 2907 (41.9) | < 0.001 |
| IV dextrose | 3933 (42.8) | 769 (34.3) | 3164 (45.6) | < 0.001 |
| IM glucagon | 3390 (36.9) | 632 (28.2) | 2758 (39.7) | < 0.001 |
Note: IM = intramuscular, IV = intravenous, SD = standard deviation.
↵* Unless stated otherwise.
↵† Includes calls where patients were transported to hospital (n = 6745) and those not transported for reasons other than refusal: transported by other ambulance (n = 147), deceased (n = 26), no patient found (n = 9), in police custody (n = 3) or with missing disposition (n = 12).
↵‡ Comparison of those who refused transport and those who did not refuse transport using the independent t test (continuous variables) or the χ2 or Fisher exact test (categorical variables) as appropriate.
↵§ Ambulance crews can be composed of emergency medical assistants and paramedics, with different scopes of practices: emergency medical assistants have the narrowest scope, followed by primary care paramedics, primary care paramedics with advanced training administering IV medications, and then advanced care paramedics.
↵¶ More than 1 type of treatment may have been administered (so the sum is greater than the total number of calls).