期刊论文详细信息
BMC Health Services Research
Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis
Pierre-Nicolas Carron1  Bertrand Yersin1  Bernard Burnand2  Valérie Pittet2 
[1] Emergency Service, Lausanne University Hospital, Lausanne, Switzerland;Institute of social & preventive medicine (IUMSP), Lausanne University Hospital, Route de la Corniche 10, CH-1010 Lausanne, Switzerland
关键词: Activity indicators;    Registers;    Public Health;    Health Services;    Epidemiology;    Pre-hospital emergency medical services;   
Others  :  1126501
DOI  :  10.1186/1472-6963-14-380
 received in 2014-02-14, accepted in 2014-09-05,  发布年份 2014
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【 摘 要 】

Background

The number of requests to pre-hospital emergency medical services (PEMS) has increased in Europe over the last 20 years, but epidemiology of PEMS interventions has little be investigated. The aim of this analysis was to describe time trends of PEMS activity in a region of western Switzerland.

Methods

Use of data routinely and prospectively collected for PEMS intervention in the Canton of Vaud, Switzerland, from 2001 to 2010. This Swiss Canton comprises approximately 10% of the whole Swiss population.

Results

We observed a 40% increase in the number of requests to PEMS between 2001 and 2010. The overall rate of requests was 35/1000 inhabitants for ambulance services and 10/1000 for medical interventions (SMUR), with the highest rate among people aged ≥ 80. Most frequent reasons for the intervention were related to medical problems, predominantly unconsciousness, chest pain respiratory distress, or cardiac arrest, whereas severe trauma interventions decreased over time. Overall, 89% were alive after 48 h. The survival rate after 48 h increased regularly for cardiac arrest or myocardial infarction.

Conclusion

Routine prospective data collection of prehospital emergency interventions and monitoring of activity was feasible over time. The results we found add to the understanding of determinants of PEMS use and need to be considered to plan use of emergency health services in the near future. More comprehensive analysis of the quality of services and patient safety supported by indicators are also required, which might help to develop prehospital emergency services and new processes of care.

【 授权许可】

   
2014 Pittet et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Pantridge JF, Geddes JS: A mobile intensive-care unit in the management of myocardial infarction. Lancet 1967, 2:271-273.
  • [2]Spaite DW, Maio R, Garrison HG, Desmond JS, Gregor MA, Stiell IG, Cayten CG, Chew JL Jr, Mackenzie EJ, Miller DR, O'Malley PJ: Emergency Medical Services Outcomes Project (EMSOP) II: developing the foundation and conceptual models for out-of-hospital outcomes research. Ann Emerg Med 2001, 37:657-663.
  • [3]Barrier G: Emergency calls in the Samu system. C R Acad Sci III 2001, 324:663-666.
  • [4]Clark MJ, FitzGerald G: Older people’s use of ambulance services: a population based analysis. J Accid Emerg Med 1999, 16:108-111.
  • [5]Kohnlein A, Kehtari R: Mobile emergency services of Neuchatel. Evaluation of two years of activity: 1996–7. Rev Med Suisse Romande 1999, 119:3-9.
  • [6]Roman MI, De Miguel AG, Garrido PC, Medina JC, Carlos AJ, Diaz G, Torres EC: Epidemiologic intervention framework of a prehospital emergency medical service. Prehosp Emerg Care 2005, 9:344-354.
  • [7]Zakariassen E, Burman RA, Hunskaar S: The epidemiology of medical emergency contacts outside hospitals in Norway–a prospective population based study. Scand J Trauma Resusc Emerg Med 2010, 18:9. BioMed Central Full Text
  • [8]Wang HE, Mann NC, Jacobson KE, Ms MD, Mears G, Smyrski K, Yealy DM: National characteristics of emergency medical services responses in the United States. Prehosp Emerg Care 2013, 17:8-14.
  • [9]Templier TL F, Vincent B, Bouvet F, Baer M, Pasteyer J: Smur des villes et smur des champs: epidemiologie de la traumatologie. Ann Fr Anesth Reanim 1997, 16:714.
  • [10]Cantineau JP, Merckx P, Reynaud P, Aussavy F, Berson C, Simon L: Toward a medical approach to the evaluation of activity in a physician-staffed mobile intensive care unit. Ann Fr Anesth Reanim 1998, 17:1217-1224.
  • [11]Dunford J, Domeier RM, Blackwell T, Mears G, Overton J, Rivera-Rivera EJ, Swor R: Performance measurements in emergency medical services. Prehosp Emerg Care 2002, 6:92-98.
  • [12]MacFarlane C, Benn CA: Evaluation of emergency medical services systems: a classification to assist in determination of indicators. Emerg Med J 2003, 20:188-191.
  • [13]Moore L: Measuring quality and effectiveness of prehospital EMS. Prehosp Emerg Care 1999, 3:325-331.
  • [14]Colwell C, Mehler P, Harper J, Cassell L, Vazquez J, Sabel A: Measuring quality in the prehospital care of chest pain patients. Prehosp Emerg Care 2009, 13:237-240.
  • [15]Liberman M, Mulder DS, Lavoie A, Sampalis JS: Implementation of a trauma care system: evolution through evaluation. J Trauma 2004, 56:1330-1335.
  • [16]Rosengart MR, Nathens AB, Schiff MA: The identification of criteria to evaluate prehospital trauma care using the Delphi technique. J Trauma 2007, 62:708-713.
  • [17]Sobo EJ, Andriese S, Stroup C, Morgan D, Kurtin P: Developing indicators for emergency medical services (EMS) system evaluation and quality improvement: a statewide demonstration and planning project. Jt Comm J Qual Improv 2001, 27:138-154.
  • [18]Staff T, Sovik S: A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway. Scand J Trauma Resusc Emerg Med 2011, 19:20. BioMed Central Full Text
  • [19]Lowthian JA, Cameron PA, Stoelwinder JU, Curtis A, Currell A, Cooke MW, McNeil JJ: Increasing utilisation of emergency ambulances. Aust Health Rev 2011, 35:63-69.
  • [20]Rucker DW, Edwards RA, Burstin HR, O’Neil AC, Brennan TA: Patient-specific predictors of ambulance use. Ann Emerg Med 1997, 29:484-491.
  • [21]Mann C, Guly H: Is the emergency (999) service being misused? Retrospective analysis. BMJ 1998, 316:437-438.
  • [22]Mears GD, Pratt D, Glickman SW, Brice JH, Glickman LT, Cabanas JG, Cairns CB: The North Carolina EMS Data System: a comprehensive integrated emergency medical services quality improvement program. Prehosp Emerg Care 2010, 14:85-94.
  • [23]Schoettker P, Potin M, Staeger P, Fuchs V, Yersin B, Ribordy V: An efficient example of a Swiss pre-hospital chain of survival: the state of Vaud model. Rev Med Suisse 2006, 2:1849-1853.
  • [24]Weiss M, Bernoulli L, Zollinger A: The NACA scale. Construct and predictive validity of the NACA scale for prehospital severity rating in trauma patients. Anaesthesist 2001, 50:150-154.
  • [25]Spaite D, Benoit R, Brown D, Cales R, Dawson D, Glass C, Kaufmann C, Pollock D, Ryan S, Yano EM: Uniform prehospital data elements and definitions: a report from the uniform prehospital emergency medical services data conference. Ann Emerg Med 1995, 25:525-534.
  • [26]Ringdal KG, Coats TJ, Lefering R, Di Bartolomeo S, Steen PA, Roise O, Handolin L, Lossius HM, Utstein TCD: The Utstein template for uniform reporting of data following major trauma: a joint revision by SCANTEM, TARN, DGU-TR and RITG. Scand J Trauma Resusc Emerg Med 2008, 16:7. BioMed Central Full Text
  • [27]Cummins RO, Chamberlain DA, Abramson NS, Allen M, Baskett PJ, Becker L, Bossaert L, Delooz HH, Dick WF, Eisenberg MS: Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Circulation 1991, 84:960-975.
  • [28]Peberdy MA, Cretikos M, Abella BS, Devita M, Goldhill D, Kloeck W, Kronick SL, Morrison LJ, Nadkarni VM, Nichol G, Nolan JP, Parr M, Tibballs J, van der Jagt EW, Young L: Recommended guidelines for monitoring, reporting, and conducting research on medical emergency team, outreach, and rapid response systems: an Utstein-style scientific statement. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiopulmonary, Perioperative, and Critical Care; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research. Resuscitation 2007, 75:412-433.
  • [29]Messelken M, Kehrberger E, Dirks B, Fischer M: The quality of emergency medical care in baden-wurttemberg (Germany): four years in focus. Dtsch Arztebl Int 2010, 107:523-530.
  • [30]Vilpert S, Ruedin HJ, Trueb L, Monod-Zorzi S, Yersin B, Bula C: Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss university hospital. BMC Health Serv Res 2013, 13:344. BioMed Central Full Text
  • [31]Lowthian JA, Jolley DJ, Curtis AJ, Currell A, Cameron PA, Stoelwinder JU, McNeil JJ: The challenges of population ageing: accelerating demand for emergency ambulance services by older patients, 1995–2015. Med J Aust 2011, 194:574-578.
  • [32]Shah MN, Bazarian JJ, Lerner EB, Fairbanks RJ, Barker WH, Auinger P, Friedman B: The epidemiology of emergency medical services use by older adults: an analysis of the National Hospital Ambulatory Medical Care Survey. Acad Emerg Med 2007, 14:441-447.
  • [33]Platts-Mills TF, Leacock B, Cabanas JG, Shofer FS, McLean SA: Emergency medical services use by the elderly: analysis of a statewide database. Prehosp Emerg Care 2010, 14:329-333.
  • [34]Vicente V, Sjostrand F, Sundstrom BW, Svensson L, Castren M: Developing a decision support system for geriatric patients in prehospital care. Eur J Emerg Med 2013, 20:240-247.
  • [35]Frank C, Seguin R, Haber S, Godwin M, Stewart GI: Medical directors of long-term care facilities: preventing another physician shortage? Can Fam Physician 2006, 52:752-753.
  • [36]Kruger AJ, Lockey D, Kurola J, Di Bartolomeo S, Castren M, Mikkelsen S, Lossius HM: A consensus-based template for documenting and reporting in physician-staffed pre-hospital services. Scand J Trauma Resusc Emerg Med 2011, 19:71. BioMed Central Full Text
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