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On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions

Published online by Cambridge University Press:  08 May 2017

Julia Tärnqvist ,
Erik Dahlén ,
Gabriella Norberg ,
Carl Magnusson ,
Johan Herlitz ,
Anneli Strömsöe ,
Christer Axelsson  and
Magnus Andersson Hagiwara
Julia Tärnqvist
Affiliation:
The Ambulance Service in Skaraborg, Lidköping, Sweden
Erik Dahlén
Affiliation:
The Ambulance Service in Skaraborg, Lidköping, Sweden
Gabriella Norberg
Affiliation:
The Prehospital Research Centre Western Sweden, University of Borås, Borås, Sweden
Carl Magnusson
Affiliation:
Ambulance and Prehospital Emergency, Sahlgrenska Univ Hospital, Gothenburg, Sweden
Johan Herlitz*
Affiliation:
The Prehospital Research Centre Western Sweden, University of Borås, Borås, Sweden Inst of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
Anneli Strömsöe
Affiliation:
School of Health and Social Sciences, University of Dalarna, SE-791 88 Falun, Sweden
Christer Axelsson
Affiliation:
The Prehospital Research Centre Western Sweden, University of Borås, Borås, Sweden Ambulance and Prehospital Emergency, Sahlgrenska Univ Hospital, Gothenburg, Sweden Inst of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
Magnus Andersson Hagiwara
Affiliation:
The Prehospital Research Centre Western Sweden, University of Borås, Borås, Sweden
*
Correspondence: Johan Herlitz, MD, PhD School of Health Sciences, Research Centre PreHospen University of Borås, Prehospital Research Centre of Western Sweden Sahlgrenska University Hospital SE-413 45 Göteborg, Sweden E-mail: [email protected]
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Abstract

Introduction

The use of Emergency Medical Services (EMS) is increasing. A number of patients call repeatedly for EMS. Early studies of frequent callers show that they form a heterogenous group.

Problem

There is a lack of research on frequent EMS callers. There is furthermore a lack of knowledge about characteristics and the prehospital assessment of the patients who call for EMS on several occasions. Finally, there is a general lack of knowledge with regard to the association between the prehospital assessment by health care providers and the final diagnosis.

Method

Patients in Skaraborg in Western Sweden, who used the EMS at least four times in 2014, were included, excluding transport between hospitals. Information on the prehospital assessment on-scene and the final diagnosis was collected from the EMS and hospital case records.

Results

In all, 339 individual patients who used the EMS on 1,855 occasions were included, accounting for five percent of all missions. Fifty percent were women. The age range was 10-98 years, but more than 50.0% were in the age range of 70-89 years.

The most common emergency signs and symptoms (ESS) codes on the scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease (eight percent).

Thirteen percent of all cases had a final diagnosis defined as a potentially life-threatening condition. Among these, 22.0% of prehospital assessments were retrospectively judged as potentially inappropriate.

Forty-nine percent had a defined final diagnosis not fulfilling the criteria for a potentially life-threatening condition. Among these cases, 30.0% of prehospital assessments were retrospectively judged as potentially inappropriate.

Conclusion:

Among patients who used EMS on multiple occasions, the most common symptoms on-scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease. In 13.0%, the final diagnosis of a potentially life-threatening condition was indicated. In a minority of these cases, the assessment on-scene was judged as potentially inappropriate.

TärnqvistJ, DahlénE, NorbergG, MagnussonC, HerlitzJ, StrömsöeA, AxelssonC, Andersson HagiwaraM. On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions. Prehosp Disaster Med. 2017;32(5):528–535.

Keywords

assessmentdiagnosisEmergency Medical Servicesmultiple use
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 5 , October 2017 , pp. 528 - 535
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest: none

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