Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Objective: To describe the process, benefits, and challenges of linking Arizona's prehospital registry to hospital discharge data. Methods: Data were queried from the Arizona Prehospital Information and Emergency Medical Services Registry System (AZ-PIERS) and the Arizona Hospital Discharge Database (HDD) for the calendar year 2015. To maximize the number of matched records, the databases were deterministically linked in 17 steps using different combinations/variations of patient personal identifiers. ⋯ The 2 steps with the highest false positive match rates were Step 16 (43.02%, n = 77) and Step 17 (31.43%, n = 11). Conclusion: It is feasible to link prehospital and hospital data using stepwise deterministic linkage; this method returns a high linkage rate with a low false positive error rate. Data linkage is vital to identifying and bridging gaps in the continuum of care and is a useful tool in statewide and agency-specific research and quality improvement.
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Catecholaminergic Polymorphic Ventricular Tachycardia is a rare but often lethal genetic disorder that affects approximately 1 in 10,000 people. It often first manifests as stress or exercise-related syncope or sudden unexplained cardiac death, primarily in the pediatric and young adult population. We present a case of a 6-year-old male who had a sudden unexplained prehospital cardiac arrest after being scared by a domestic animal and who presented in ventricular fibrillation. ⋯ During the course of care, medications with beta-1 and -2 agonist properties were administered, followed by multiple further episodes of polymorphic ventricular tachycardia (PVT)/ventricular fibrillation (VF). Once these medications were discontinued and beta blockers were administered, the patient had no further episodes of PVT/VF and was subsequently discharged from hospital 7 days later, completely neurologically intact. This case suggests the need for caution when considering administering beta agonists in a pediatric cardiac arrest patient with no known history of heart disease who presents in VF or PVT after an incident of extreme stress or strenuous physical activity.