BMC Emergency Medicine最新文献

{"title":"The rate and predictors of violence against EMS personnel.","authors":"Jani Paulin, Mari Lahti, Heikki Riihimäki, Joonas Hänninen, Tero Vesanen, Mari Koivisto, Laura-Maria Peltonen","doi":"10.1186/s12873-024-01116-5","DOIUrl":"10.1186/s12873-024-01116-5","url":null,"abstract":"<p><strong>Background: </strong>Violence against Emergency Medical Services (EMS) personnel vary between studies. Current studies are mainly based on self-reporting, thus other designs are needed to provide more perspective. The purpose of this study was to explore the rate and predictors of violent behavior targeted at EMS personnel by exploring the Electronic patient care records (ePCR) documentation by EMS personnel.</p><p><strong>Methods: </strong>This was a retrospective cohort study of EMS patients in Finland. The data were collected from three regions between 1st June and 30th November 2018. Text mining and manual evaluation were used to identify and explore predictors of violence targeted at EMS personnel from the ePCR narratives. Multivariable logistic regressions were used to determine factors that were independently associated with violent behavior. The results are presented with odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>The EMS personnel reported experiences of violence in a total of 297 identified missions (0.7%) of all EMS missions (n = 40,263). The violence was mostly verbal (62.3%) and the most common violence perpetrator was the patient (98.0%). The police were alarmed to many missions where violence was reported (40.7%). Sometimes violence occurred suddenly although the police were present. The multivariable logistic regression model indicates that violence occurred typically in urban areas (OR 1.699; 95% CI 1.283 to 2.248), at weekend nights (OR 1.357; 95% CI 1.043 to 1.765), by male (OR 1.501; 95% CI 1.160 to 1.942), and patients influenced by alcohol (OR 3.464; 95% CI 2.644 to 4.538). A NEWS2 score of 3 in any parameter (vs. score 0-4, OR 2.386; 95% CI: 1.788 to 3.185) and ALS unit type (vs. BLS, OR 1.373; 95% CI: 1.009 to 1.866) increased the likelihood as well.</p><p><strong>Conclusions: </strong>The documentation in ePCRs show low rates of violence targeted at EMS personnel. However, violence is a multidimensional phenomenon connected to unfamiliar patients, rushed situations, and an uncontrolled environment. This means that the EMS personnels' safety cannot be ensured in all situations. Therefore, a balance between safety margins and treating patients needs to be considered.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"200"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious conditions among conveyed and non-conveyed patients presenting with nonspecific chief complaints to the ambulance service.","authors":"Robert Ivic-Morén, Katarina Bohm, Veronica Vicente, Emelie Arvidsson, Maaret Castrén, Lisa Kurland","doi":"10.1186/s12873-024-01106-7","DOIUrl":"10.1186/s12873-024-01106-7","url":null,"abstract":"<p><strong>Background: </strong>It is a challenge for the ambulance service to identify which patients to convey to the emergency department (ED). Ideally this would be the patients with serious conditions requiring further care in the ED. However, patients presenting with non-specific chief complaints are difficult to prioritize and typically have normal or near normal vital signs despite up to one third having underlying serious conditions. The proportion of patients with serious conditions among non-conveyed patients with non-specific chief complaints (NSC) as assessed by ambulance clinicians is not known. Therefore, the primary aim was to study the proportion of serious conditions among conveyed and non-conveyed patients presenting to the ambulance service with NSCs. The secondary aim was to study the mortality rate among patients with NSCs in relation to conveyance and serious and nonserious conditions.</p><p><strong>Method: </strong>A retrospective cohort study of patients ≥ 18 years of age presenting with NSCs to the ambulance service in Stockholm Region between January 1st, 2013 and December 31st, 2013. Patients were identified via the ambulance service electronic health record and followed via records from the the National Patient Register and Causes of Death Registry at Sweden's National Board for Health and Welfare. Descriptive statistics as well as regression analyses were used.</p><p><strong>Results: </strong>A total of 4744 patients were included with a median age of 76 years. A serious condition was present in 1398 (29.5%) of the patients. After index assessment by the ambulance service, 3780 (79.7%) were conveyed of which 1334 (35.3%) had serious conditions, compared to 964 (20.3%) who were non-conveyed of which 64 (6.6%) had serious conditions. 30-day mortality was 372 (9.8%) in the conveyance group compared to 32 (3.3%) in the non-conveyance group. If serious conditions were present, the mortality rates were 269 (20.2%) in the conveyance group compared to 11 (17.2%) in the non-conveyance group.</p><p><strong>Conclusion: </strong>The results show that serious conditions were more than five times more common among conveyed as compared to non-conveyed patients. Mortality rates were three times higher in the conveyance group as compared to the non-conveyance group. Our results suggest that the ambulance personnel play an important role in identifying patients with serious conditions, hence, likely to be in need of treatment in the ED.</p><p><strong>Trial registration: </strong>N/A.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"199"},"PeriodicalIF":2.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142494651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prehospital mechanical cardiopulmonary resuscitation use for out-of-hospital cardiac arrest: an observational study.","authors":"Ying-Kuo Liu, Liang-Fu Chen, Szu-Wei Huang, Shih-Chan Hsu, Chin-Wang Hsu, Jen-Tang Sun, Shu-Hui Chang","doi":"10.1186/s12873-024-01115-6","DOIUrl":"10.1186/s12873-024-01115-6","url":null,"abstract":"<p><strong>Background: </strong>The use of mechanical cardiopulmonary resuscitation device has been very prevalent in out-of-hospital cardiac arrest rescue. This study aimed to investigate whether the timing of mechanical cardiopulmonary resuscitation device set-up correlated with the the outcome of cardiac arrest patients.</p><p><strong>Methods: </strong>We retrospectively reviewed adult nontrauma cardiac arrest cases in New Taipei City, Taiwan, from January to December 2022. Demographic data, intervention-related factors, and the time variables of mechanical cardiopulmonary resuscitation were collected. The outcomes included the return of spontaneous circulation and 24-hour survival. We compared patients who achieved spontaneous circulation and those who did not with univariate and multivariable regression analyses.</p><p><strong>Results: </strong>In total, 1680 patients who received mechanical cardiopulmonary resuscitation were included in the analysis. Reducing the time interval from manual chest compression initiation to device setup was independently associated with the return of spontaneous circulation and 24-hour survival, especially in the subgroup of patients of initial shockable rhythm. Receiver operating characteristic analysis revealed that the outcome of patients with an initial shockable rhythm could be predicted by the mechanical cardiopulmonary resuscitation setup time, with areas under the curve of 60.8% and 63.9% for ROSC and 24-hour survival, respectively. The cutoff point was 395.5 s for patients with an initial shockable rhythm.</p><p><strong>Conclusion: </strong>A positive correlation was found between early mechanical cardiopulmonary resuscitation intervention and the outcomes of out-of-hospital cardiac arrest patients. The time between manual chest compression and device setup could predict the return of spontaneous circulation and 24-hour survival in the subgroup of patients with initially shockable rhythm with the optimal cutoff point at 395.5 s.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"198"},"PeriodicalIF":4.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the crowding of emergency departments: an assessment of the NEDOCS in Lombardy, Italy, and the development of a new objective indicator based on the waiting time for the first clinical assessment.","authors":"Fabiola Signorini, Giovanni Nattino, Carlotta Rossi, Walter Ageno, Felice Catania, Francesca Cortellaro, Giorgio Costantino, Andrea Duca, Giulia Irene Ghilardi, Stefano Paglia, Paolo Pausilli, Cristiano Perani, Giuseppe Sechi, Guido Bertolini","doi":"10.1186/s12873-024-01112-9","DOIUrl":"https://doi.org/10.1186/s12873-024-01112-9","url":null,"abstract":"<p><strong>Background: </strong>There is no ubiquitous definition of Emergency Department (ED) crowding and several indicators have been proposed to measure it. The National ED Overcrowding Study (NEDOCS) score is among the most popular, even though it has been severely criticised. We used the waiting time for the physician's initial assessment to evaluate the performance of the NEDOCS and proposed a new crowding indicator based on this objective measure.</p><p><strong>Methods: </strong>To evaluate the NEDOCS, we used the 2022 data of all the Lombardy EDs and compared the distribution of waiting times across the five levels of the NEDOCS at ED arrival. To construct the new indicator, we estimated the centre-specific relationship between the total number of ED patients and the waiting time of those with minor or deferrable urgency. We defined seven classes of waiting times and calculated how many patients corresponded to an average waiting time in the classes. These centre-specific cutoffs were used to define the 7-level crowding indicator. The indicator was then compared to the NEDOCS score and validated on the first six months of 2023 data.</p><p><strong>Results: </strong>Patients' waiting time did not increase at the increase of the NEDOCS score, suggesting the absence of a relationship between this score and the effect of ED crowding on the ED capacity of evaluating new patients. The indicator we propose is easy to estimate in real-time and based on centre-specific cutoffs, which depend on the volume of yearly accesses. We observed minimal agreement between the proposed indicator and the NEDOCS in most EDs, both in the development and validation datasets.</p><p><strong>Conclusions: </strong>We proposed to quantify ED crowding using the waiting time for physician's initial assessment of patients with minor or deferrable urgency, which increases in crowding situations due to the prioritization of urgent patients. The centre-specific cutoffs avoid the problem of the heterogeneity of the volume of accesses and organization among EDs, while enabling a fair comparison between centres.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"196"},"PeriodicalIF":2.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-care strategies used by disaster responders after the 2023 earthquake in Turkey and Syria: a mixed methods study.","authors":"Karin Blomberg, Jason Murphy, Karin Hugelius","doi":"10.1186/s12873-024-01105-8","DOIUrl":"https://doi.org/10.1186/s12873-024-01105-8","url":null,"abstract":"<p><strong>Background: </strong>Disaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023.</p><p><strong>Methods: </strong>A study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023.</p><p><strong>Results: </strong>The most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned.</p><p><strong>Conclusion: </strong>Given the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"195"},"PeriodicalIF":2.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with preventable drug-related emergency department visits (DRED_p) in elderly patients.","authors":"Parinya Phoemlap, Somratai Vadcharavivad, Khrongwong Musikatavorn, Nutthada Areepium","doi":"10.1186/s12873-024-01102-x","DOIUrl":"https://doi.org/10.1186/s12873-024-01102-x","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of emergency department (ED) visits among the elderly is high and increasing. While emergency services for the elderly involve many factors, drug-related problems (DRPs) that can worsen patient conditions are less frequently discussed. This study investigates the prevalence of preventable drug-related ED visits (DRED_p) and the characteristics of DRPs in elderly ED patients through a comprehensive medication review.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a non-trauma ED of a university-affiliated tertiary-care hospital. All adult patients aged 60 years and older who were on medications and visited the ED were included. A clinical pharmacist conducted comprehensive medication reviews for each patient. Patients were classified as experiencing drug-related ED visits (DRED) if their primary reason for the visit was associated with a DRP, as determined by both the physician and pharmacist. DRPs attributed to medication errors were categorized as preventable, while other DRPs were assessed for preventability using modified Schumock and Thornton criteria.</p><p><strong>Results: </strong>The study involved 351 patients with a mean age of 75.5 years (SD 9.3) and an equal male-to-female ratio of ED visits. The median number of comorbidities was five (IQR 3-6), with about half of the patients taking ten or more medications. The interdisciplinary team classified 43 patients (12.3%) as DRED_p, accounting for 58.1% of the 74 (21.1%) drug-related ED visits. All medication errors categorized as causing harm (level E and higher) occurred within the DRED_p group, constituting approximately half of all DRED_p (22 cases, 51.2%). Approximately two-thirds of drug-related ED visits were associated with adverse drug events (ADEs), predominantly involving antithrombotics, oral hypoglycemic agents, and antineoplastics. Multivariable analysis identified that ED visits involving potentially inappropriate medications (PIMs) according to the STOPP criteria and the presence of multiple comorbidities (six or more concurrent diseases) were significantly associated with DRED_p.</p><p><strong>Conclusions: </strong>About one in ten elderly patients visited the ED due to preventable DRPs. The majority of DRPs leading to ED visits were ADEs. Both the prescription of PIMs and the presence of multiple comorbidities were significantly associated with DRED_p.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"197"},"PeriodicalIF":2.3,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital factors associated with mortality among road traffic injury patients: analysis of Cameroon trauma registry data.","authors":"Serge Ngekeng, Odette Kibu, Rasheedat Oke, Nahyeni Bassah, Darwin Arole Touko, Mark T Yost, Fanny Dissak-Delon, Nicholas Tendongfor, Georges Nguefack-Tsague, Alan Hubbard, Sandra I McCoy, S Ariane Christie, Alain Chichom-Mefire, Catherine Juillard","doi":"10.1186/s12873-024-01113-8","DOIUrl":"https://doi.org/10.1186/s12873-024-01113-8","url":null,"abstract":"<p><strong>Background: </strong>Cameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon.</p><p><strong>Methods: </strong>We included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI.</p><p><strong>Results: </strong>RTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08-2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1-3.67) and scene care (AOR = 0.25, 95%CI = 0.04-0.80).</p><p><strong>Conclusions: </strong>Receiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"194"},"PeriodicalIF":2.3,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of intraosseous access during resuscitation: a retrospective cohort study.","authors":"Tim W H Rijnhout, Marin Kieft, Willemijn M Klein, Edward C T H Tan","doi":"10.1186/s12873-024-01103-w","DOIUrl":"https://doi.org/10.1186/s12873-024-01103-w","url":null,"abstract":"<p><strong>Purpose: </strong>During resuscitation in emergency situations, establishing intravascular access is crucial for promptly initiating delivery of fluids, blood, blood products, and medications. In cases of emergency, when intravenous (IV) access proves unsuccessful, intraosseous (IO) access serves as a viable alternative. However, there is a notable lack of information concerning the frequency and efficacy of IO access in acute care settings. This study aims to assess the efficacy of intraosseous (IO) access in acute care settings, especially focusing on children in a level 1 trauma center.</p><p><strong>Methods: </strong>This retrospective study included patients with IO access presented in a level 1 trauma center emergency department (ED) between January 2015 and April 2020. Data regarding medication and fluid infusion was documented, and the clinical success rate was calculated.</p><p><strong>Results: </strong>Of the 109,548 patients that were admitted to the ED, 25,686 IV lines were inserted. Documentation of 188 patients of which 73 (38.8%) children was complete and used for analysis. In these 188 patients, a total of 232 IO accesses were placed. Overall, 182 patients had a functional IO access (204 needles) (88%). In children (age < 18 years) success rate was lower as compared to adults, 71-84% as compared to 94%. However, univariate regression showed no association between the percentage of functional IO access and gender, age, weight, health care location (prehospital and in hospital), anatomical position (tibia as compared to humerus) or type of injury.</p><p><strong>Conclusion: </strong>Intraosseous access demonstrates a high success rate for infusion, independent of gender, age, weight, anatomical positioning, or healthcare setting, with minimal complication rates. Caution is especially warranted for children under the age of six months, since success rate was lower.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"192"},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11475784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between the accuracy of the emergency response centre's urgency assessment and emergency medical services non-conveyance: a retrospective register-based study in Finland.","authors":"Tomi Salminen, Kaius Kaartinen, Mira Palonen, Piritta Setälä, Eija Paavilainen, Sanna Hoppu","doi":"10.1186/s12873-024-01108-5","DOIUrl":"https://doi.org/10.1186/s12873-024-01108-5","url":null,"abstract":"<p><strong>Background: </strong>In modern emergency medical services (EMS), ambulances increasingly focus on examining and treating the patient at the scene. This has led to increased levels of non-conveyance. In Finland, for instance, approximately 40% of EMS dispatches end up in non-conveyance. As EMS systems evolve, the proportion of non-conveyance could serve as a cost-effective measure to assess the quality of the dispatch criteria, if a link to the performance of urgency assessment would be established. The purpose of this study was to investigate whether the proportion of non-conveyance is associated with the test performance levels of the urgency assessment. This investigation was done separately within each dispatch category.</p><p><strong>Methods: </strong>A retrospective evaluation of the data was conducted on all EMS dispatches in the Pirkanmaa Hospital District from 1 August 2021 through 31 August 2021. There were a total of 7,245 EMS dispatches during the study period of which 829 were excluded. This study was conducted by comparing the existing test performance levels (sensitivity, specificity and under- or overestimation) of the emergency response centre's urgency assessment with the non-conveyance rate (%) of each dispatch category. The relationships between the variables were measured using Spearman's rank correlation coefficient.</p><p><strong>Results: </strong>The proportion of over-triage was the only urgency assessment's test performance variable that had a statistically significant correlation with the proportion of non-conveyance (r = 0.568; p = 0.003). Other test performance variables of the urgency assessment had no or little correlation to the proportion of non-conveyance. Of the 6,416 EMS dispatches in the study period, 42% (2,672) resulted in non-conveyance of the patient. In nine dispatch categories, at least half (51-69%) of the dispatches ended in non-conveyance.</p><p><strong>Conclusions: </strong>Based on this study, it seems that the percentage of non-conveyance in the dispatch category could be used, with certain limitations, to assess the proportion of over-triage in the dispatch category. The method is particularly applicable in scenarios where the dispatch criteria have undergone modifications and there is a need to monitor the effect of the changes on the level of over-triage.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"193"},"PeriodicalIF":2.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequent contacts to Emergency Medical Services (EMS): more than frequent callers.","authors":"Astrid K V Harring, Ola Graesli, Kristin Häikiö, Magnus Hjortdahl, Trine M Jørgensen","doi":"10.1186/s12873-024-01104-9","DOIUrl":"https://doi.org/10.1186/s12873-024-01104-9","url":null,"abstract":"<p><strong>Background: </strong>A frequent caller is defined by The Frequent Caller National Network (FreCaNN) as an adult who makes five or more emergency calls in a month or twelve or more in three months, related to individual episodes of care. However, we believe that when limiting the definition to those who call themselves, one underestimates the impact frequent contacts have on the Emergency Medical Communication Center (EMCC) and the Emergency Medical Services (EMS).</p><p><strong>Method: </strong>We conducted a descriptive retrospective cross-sectional database review of frequent contacts; defined as persons who have ≥ 5 contacts in a month or ≥ 12 contacts in three months. Data were provided from Oslo EMCC, between 1. January 2017 and 31. December 2022. Contrary to the FreCaNN definition, we included all types of contacts and callers, both emergent and non-emergent, regarding patients of all ages.</p><p><strong>Results: </strong>During the study period, 2.149.400 contacts were registered. Of these 129.700 were contacts from frequent callers, where the patients called themselves. When including contacts frequently made on behalf of a patient, we found that 268.723 fit the definition of frequent emergency contacts. When also taking non-emergent contacts into account, a total of 437.361 contacts fit the definition of frequent contacts.</p><p><strong>Conclusion: </strong>When limiting the criteria to only frequent callers, one underestimates the impact persons who have frequent contacts, have on the EMCC and the EMS. We were able to distinguish between three categories-contacts from frequent callers, frequent emergency contacts, and frequent contacts. We believe broadening the definition can benefit both research and audits, when accessing the use of emergency resources to patients with frequent requests for help to the EMCCs.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"24 1","pages":"190"},"PeriodicalIF":2.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}