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

Abstract

<div lang="en" class="abs"><p class="abs_header">Abstract</p><p><em>Background:</em> 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.</p><p><em>Methods:</em> 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.</p><p><em>Results:</em> 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.</p><p><em>Conclusions:</em> 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.</p></div>