Non-transport emergency medical service missions - a retrospective study based on medical charts
Non-transport emergency medical service missions - a retrospective study based on medical charts
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DOI：
10.1111/aas.13071
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发表时间：
2018-05-01
影响因子：
2.1
通讯作者：
Elo, S.
中科院分区：
文献类型：
--
作者：
Pekanoja, S.;Hoikka, M.;Elo, S.
背景：在芬兰，大约40%的紧急医疗服务（EMS）任务没有将病人用救护车运送到医院，而决定不运送病人的原因也各不相同。这项研究的目的是描述这些紧急医疗服务非运输任务的背景。方法回顾性收集2014年9月3日至10月20日非运输EMS图表（n=1154）。从EMS图表中提取事件信息和患者主要症状，并使用内容和统计分析进行量化。结果患者对EMS的需求由多种原因解释。三分之一的急诊是由器官特异性症状引起的，而30.8%的急诊原因不明。38.4%的病例出现突发症状，而14.7%的病例在接触EMS前症状持续数天或数周。在79.2%的任务中，EMS人员提供指导而不是治疗。结论非运输任务是EMS的重要日常工作量。虽然大多数症状表现为急性发作，但这些特派团大多数只涉及医疗必要性评估和（或）指导，而没有任何医疗。EMS的这种使用是否对任何医疗保健系统都具有成本效益是值得怀疑的。
BackgroundIn 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.MethodsThe 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.ResultsPatients 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.ConclusionsNon-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.