Assessment of Bystander Intervention on EMS Transport Decisions for Cases of Alcohol Intoxication at a Small Liberal Arts College

This is the authors' abstract. We don't add key points for this paper.

Background: Collegiate emergency medical technicians (EMTs) often encounter patients with uncomplicated alcohol intoxication who may refuse transport to an emergency department (ED), but research lacks on the influence of bystander intervention on an EMT's decision to let a patient refuse transport.Objective: We investigated how bystander intervention influences transport decisions in cases of alcohol intoxication at a small college in New York State.Methods: Data were collected from prehospital care reports (PCRs) archived by the college's emergency medical services between 2014 and 2018.Included data were collected on alcohol intoxication cases (n = 190) and categorized by transport decision, nature of bystander intervention, and patient's sex.Interactions between bystander intervention and transport decision were assessed by calculation of relative risks of ED transport and creation of a loglinear model.Results: Bystanders were present in a majority of cases, and a majority of bystanders offered to provide care following refusal of transport.Bystander presence was not associated with a significant difference in transport decision.However, when bystanders were present, offering care was associated with a 73% reduction in ED transport.Conclusions: Bystander care was found to be associated with a decreased relative risk of ED transport.However, documentation of bystander intervention in PCRs was often ambiguous.We highlight the need for better bystander intervention documentation in PCRs to improve research on this topic.