Identification of Risk Patients in Emergency Medical Services

Background: Inadequate nutrition has been associated with growing risk of falling and impaired ability in elderly patients. Falling is a significant threat to the health of the elderly. It is estimated that one third of people over the age of 65 experience at least one falling each year. Over 60% of the falls cause serious injury or disability. Adequate nutrition increases the muscle strength of the elderly. Therefore, determining and managing the nutrition level is important for preventing falling. As far as we know emergency medical services has never before reported being a part of prevention by performing risk identification.

Study Overview

• Status: Completed
• Conditions: Cognitive Impairment; Malnutrition; Falling
• Intervention / Treatment: Other: Observation

Detailed Description

Aim: The purpose of the study is to assess whether it is possible to use a simple screening tool to find out the risk of falling, the nutritional status and the level of cognitive functioning activity when the EMS faces the elderly over the age of 70 years. In addition, the flow of information between primary care and emergency services and nutritionists is examined.

Material and method: Identification of poor nutrition is carried out in the Helsinki University hospital area. All people over the age of 70 requiring ambulance transport will be included in the study for 4 months during 2018. A structured electronic form is used to identify the malnutrition, the level of cognitive functioning activity and the risk of falling. The assessment is performed during the transport. The data is analyzed by the SPSS statistical program both by descriptive and statistical significance by looking at the methods suitable for the data.

Conclusion: The information produced by the research aims to develop (a) Identifying in the ambulance those patients who are at risk; and (b) activating nursing staff and nutritionists and, by means of these measures, increase the number of patients receiving effective nutrition therapy.

• Study Type: Observational
• Enrollment (Actual): 500

Contacts and Locations

Study Locations

• Finland
  • Helsinki Usimaa
    • Helsinki, Helsinki Usimaa, Finland
      • Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 70 years to 104 years (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

All people over the age of 70 requiring ambulance transport will be included in the study for 4 months during 2018 in the Helsinki University hospital area.

Description

Inclusion Criteria:

• All people over the age of 70 requiring ambulance transport will be included in the study for 4 months during 2018.

Exclusion Criteria:

-

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Identifying in the ambulance those patients who are at risk (over 3 points in a single section)	to use a simple screening tool to find out the risk of falling, the nutritional status and the level of cognitive functioning activity when the EMS faces the elderly over the age of 70 The risk-screening tool is based on valid scales. RISK SCREENING TOOL; Risk of falling: Prediction of falls (4 items, 0-3 points) Self-reporting of falls over a 12-month period (3 items, 0-3 points) Malnutrition Risk: Home care and meal services (Yes, No) Nutritional status (4 items, 0-3 points) Effect of the diseases on nutrition (4 items, 0-3 points) Age (1 item, 1 point) Delirium and cognitive functioning: Alertness / memory / attention deficit / symptoms (4 items, 0-3 points) Complete when: > 70 years patient The patient's physical state allows. Mostly completed during transport (no need to add actual time on scene). Possible risk points are reported at donation to the emergency department.	Through study completion an average of 12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Identifying in the ambulance those patients who are at risk (total scores over sections)	Subscales are combined to compute a total score, if more than three points in total, the patient is considered to be a risk patient.	Through study completion an average of 12 months

Collaborators and Investigators

• Sponsor: Helsinki University Central Hospital
• Collaborators: University of Helsinki

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2018
• Primary Completion (Actual): January 28, 2022
• Study Completion (Actual): January 28, 2022

Study Registration Dates

• First Submitted: November 15, 2018
• First Submitted That Met QC Criteria: November 28, 2018
• First Posted (Actual): November 29, 2018

Study Record Updates

• Last Update Posted (Actual): January 31, 2022
• Last Update Submitted That Met QC Criteria: January 28, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: nutrition; elderly; falling; EMS; cognitive functioning
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Nutrition Disorders; Emergencies; Malnutrition
• Other Study ID Numbers: §50, 27.3.2018

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No