Non-transport emergency medical service missions - a retrospective study based on medical charts

Acta Anaesthesiol Scand. 2018 May;62(5):701-708. doi: 10.1111/aas.13071. Epub 2018 Jan 24.

Abstract

Background: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport missions.

Methods: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non-transport EMS charts (n = 1154). Event information and patients' main symptoms were extracted from information found in EMS charts and quantified using content and statistical analyses.

Results: Patients' need for EMS were explained by various reasons. One-third of the missions were caused by organ-specific symptoms, whereas in 30.8% of cases the reason for EMS was unspecified. Sudden onset symptoms were noted for 38.4% of the cases, whereas in 14.7% of cases the symptoms had persisted for days or weeks before EMS contact. EMS personnel offered guidance instead of treatment in 79.2% of the missions.

Conclusions: Non-transport missions represent a significant daily work load for the EMS. Although most of the symptoms showed acute onset, the majority of these missions involved only assessment of medical necessity and/or guidance without any medical treatment. It is questionable whether this use of the EMS is cost-effective for any healthcare system.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Emergency Medical Services*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Transportation of Patients*
  • Young Adult