Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis

Authors: Valérie Pittet, Bernard Burnand, Bertrand Yersin, Pierre-Nicolas Carron

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

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.
Appendix
Available only for authorised users
Literature
1.
Pantridge JF, Geddes JS: A mobile intensive-care unit in the management of myocardial infarction. Lancet. 1967, 2: 271-273.CrossRefPubMed
2.
Spaite DW, Maio R, Garrison HG, Desmond JS, Gregor MA, Stiell IG, Cayten CG, Chew JL, 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. 10.1067/mem.2001.115215.CrossRefPubMed
3.
Barrier G: Emergency calls in the Samu system. C R Acad Sci III. 2001, 324: 663-666. 10.1016/S0764-4469(01)01334-8.CrossRefPubMed
4.
Clark MJ, FitzGerald G: Older people’s use of ambulance services: a population based analysis. J Accid Emerg Med. 1999, 16: 108-111. 10.1136/emj.16.2.108.CrossRefPubMedPubMedCentral
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.PubMed
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. 10.1080/10903120590962157.CrossRefPubMed
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: 9-10.1186/1757-7241-18-9.CrossRefPubMedPubMedCentral
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. 10.3109/10903127.2012.722178.CrossRefPubMed
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.CrossRef
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. 10.1016/S0750-7658(99)80027-6.CrossRefPubMed
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. 10.1080/10903120290938896.CrossRefPubMed
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. 10.1136/emj.20.2.188.CrossRefPubMedPubMedCentral
13.
Moore L: Measuring quality and effectiveness of prehospital EMS. Prehosp Emerg Care. 1999, 3: 325-331. 10.1080/10903129908958963.CrossRefPubMed
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. 10.1080/10903120802706138.CrossRefPubMed
15.
Liberman M, Mulder DS, Lavoie A, Sampalis JS: Implementation of a trauma care system: evolution through evaluation. J Trauma. 2004, 56: 1330-1335. 10.1097/01.TA.0000071297.76727.8B.CrossRefPubMed
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. 10.1097/01.ta.0000197150.07714.c2.CrossRefPubMed
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.PubMed
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: 20-10.1186/1757-7241-19-20.CrossRefPubMedPubMedCentral
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. 10.1071/AH09866.CrossRefPubMed
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. 10.1016/S0196-0644(97)70221-X.CrossRefPubMed
21.
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. 10.3109/10903120903349846.CrossRefPubMed
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.PubMed
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. 10.1007/s001010170030.CrossRefPubMed
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. 10.1016/S0196-0644(95)70271-7.CrossRefPubMed
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: 7-10.1186/1757-7241-16-7.CrossRefPubMedPubMedCentral
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. 10.1161/01.CIR.84.2.960.CrossRefPubMed
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. 10.1016/j.resuscitation.2007.09.009.CrossRefPubMed
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.PubMedPubMedCentral
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: 344-10.1186/1472-6963-13-344.CrossRefPubMedPubMedCentral
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.PubMed
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. 10.1197/j.aem.2007.01.019.CrossRefPubMed
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. 10.3109/10903127.2010.481759.CrossRefPubMed
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. 10.1097/MEJ.0b013e328356452d.CrossRefPubMed
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.PubMed
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: 71-10.1186/1757-7241-19-71.CrossRefPubMedPubMedCentral
Metadata
Title
Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis
Authors
Valérie Pittet
Bernard Burnand
Bertrand Yersin
Pierre-Nicolas Carron
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-380

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue

Research article

Should health insurers target prevention of cardiovascular disease?: a cost-effectiveness analysis of an individualised programme in Germany based on routine data

Research article

Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services

Research article

Field methods in medical record abstraction: assessing the properties of comparative effectiveness estimates

Research article

Distance decay and persistent health care disparities in South Africa

Debate

Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness

Study protocol

Impact of a program to prevent incivility towards and assault of healthcare staff in an ophtalmological emergency unit: study protocol for the PREVURGO On/Off trial