Characteristics of non-conveyed patients in emergency medical services (EMS): a one-year prospective descriptive and comparative study in a region of Sweden

Abstract Background There has been an increasing demand for emergency medical services (EMS), and a growing number of patients are not conveyed; i.e., they are referred to levels of care other than ambulance conveyance to the emergency department. Patient safety issues have been raised regarding the ability of EMS to decide not to convey patients. To improve non-conveyance guidelines, information is needed about patients who are not conveyed by EMS. Therefore, the purpose of this study was to describe and compare the proportion and characteristics of non-conveyed EMS patients, together with assignment data. Methods A descriptive and comparative consecutive cohort design was undertaken. The decision of whether to convey patients was made by EMS according to a region-specific non-conveyance guideline. Non-conveyed patients’ medical record data were prospectively gathered from February 2016 to January 2017. Analyses was conducted using the chi-squared test, two-sample t test, proportion test and Mann-Whitneys U-test. Results Out of the 23,250 patients served during the study period, 2691 (12%) were not conveyed. For non-conveyed adults, the most commonly used Emergency Signs and Symptoms (ESS) codes were unspecific symptoms/malaise, abdomen/flank/groin pain, and breathing difficulties. For non-conveyed children, the most common ESS codes were breathing difficulties and fever of unclear origin. Most of the non-conveyed patients had normal vital signs. Half of all patients with a designated non-conveyance level of care were referred to self-care. There were statistically significant differences between men and women. Conclusions Fewer patients were non-conveyed in the studied region compared to national and international non-conveyance rates. The differences seen between men and women were not of clinical significance. Follow-up studies are needed to understand what effect patient outcome so that guidelines might improve.

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Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

Netherlands Heart Journal ◽

10.1007/s12471-021-01545-y ◽

2021 ◽

Vol 29 (4) ◽

pp. 224-229 ◽

Cited By ~ 1

Author(s):

E. R. de Koning ◽

M. J. Boogers ◽

J. Bosch ◽

M. de Visser ◽

M. J. Schalij ◽

...

Keyword(s):

Chest Pain ◽

Emergency Medical Services ◽

Medical Services ◽

Cardiac Symptoms ◽

Emergency Medical ◽

Time Period ◽

Number Of Patients ◽

St Elevation ◽

Pain Patients ◽

Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

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Emergency Patients with Mental Crisis Accessing Emergency Medical Services in Thailand

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19002723 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s126-s126

Author(s):

Porntip Wachiradilok

Keyword(s):

Emergency Medical Services ◽

Winter Season ◽

Psychiatric Hospitals ◽

Medical Services ◽

Knowledge And Skills ◽

Emergency Patients ◽

Emergency Team ◽

Emergency Medical ◽

Number Of Patients ◽

Insufficient Knowledge

Introduction:Emergency responders face an increasing number of calls involving people with behavioral and mental crisis issue. Integrated multi-agency schemes involving ambulance, police and mental health services are now being developed to provide urgent and emergency care pathways for these vulnerable patients.Aim:The objectives were to study the situation, characteristics, issues, and accessibility to emergency medical services (EMS) and appropriate treatment for emergency patients with a mental crisis in Thailand.Methods:The sample included 26,511 mental crisis patients accessing EMS. Data were obtained from the database of the Information Technology for Emergency Medical System between 2015-2017 and from stakeholders from four provinces distributed regionally using focus groups and in-depth interviews. The data were analyzed using descriptive statistics and content analysis.Results:The number of patients with mental crisis accessing EMS increased in the past three years. Most patients are male in the working age group from the Northeastern area during the raining and winter season, especially between September and October. During patient encounters with maniacal attacks, assistance will be requested from the police and the emergency medical units. The response depends on the experience and community capability. The emergency responder teams had insufficient knowledge and skills. Emergency rooms in most hospitals lack specific caring unit. Psychiatric hospitals have different criteria for admitting patients. Most had no fast track system and even refuse admittance.Discussion:Mental crisis patient calls with EMS were rising. However, accessibility to appropriate service centers was still an issue. Most hospitals lack prioritized access and staffs had insufficient knowledge and skills. Cooperation among the police, emergency medical operation team and the rapid psychiatric emergency team is need to be reinforced.

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Humanização da assistência: acolhimento e triagem na classificação de risco

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v13i4a238728p997-1005-2019 ◽

2019 ◽

Vol 13 (4) ◽

pp. 997

Author(s):

Alexandre Lins Werneck ◽

Carla Fernanda Batista Paula ◽

Rita de Cássia Helu Mendonça Ribeiro

Keyword(s):

Emergency Medical Services ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Risk Classification ◽

Medical Services ◽

Sectional Study ◽

Cross Sectional ◽

Emergency Medical ◽

Number Of Patients ◽

Practical Implications

RESUMOObjetivo: estabelecer relações entre a humanização da assistência e o acolhimento e a triagem na classificação de risco pela enfermagem nos serviços médicos de emergência. Método: trata-se de um estudo quantitativo, analítico, transversal. Utilizou-se um questionário e entrevistaram-se 80 pacientes que estavam em consulta de enfermagem. Utilizaram-se a análise descritiva, médias, desvio padrão, mediana, mínimo e máximo, frequência e percentual. Apresentaram-se os resultados em forma de tabelas. Resultados: verificou-se que, dos 64 pacientes, a maioria era do sexo feminino, na faixa etária entre 21 a 40 anos e casada, e cinco pacientes esperaram mais que o tempo preconizado, sendo que a Ortopedia/Traumatologia foi a especialidade com maior número de pacientes atendidos. Conclusão: chegou-se à conclusão de que os usuários estão satisfeitos com a atuação da Enfermagem na humanização da assistência, no acolhimento e na triagem com classificação de risco, nos serviços médicos de emergência. Infere-se que as considerações sobre as implicações teóricas ou práticas dos resultados e a contribuição do estudo para o avanço do conhecimento científico são estabelecer relações entre a humanização da assistência e o acolhimento e a triagem com classificação de risco nos serviços médicos de emergência. Espera-se encontrar situações em que há falta de humanização e colocá-las em evidência, propondo mudanças. Descritores: Humanização da Assistência; Acolhimento; Triagem; Classificação; Risco; Enfermagem de Emergência.ABSTRACT Objective: to establish relations between the humanization of care and the reception and screening in risk classification by nursing in emergency medical services. Method: this is a quantitative, analytical, cross-sectional study. A questionnaire was used and 80 patients who were in nursing consultation were interviewed. Descriptive analysis, means, standard deviation, median, minimum and maximum, frequency and percentage were used. Results were presented in the form of tables. Results: it was verified that, of the 64 patients, the majority were female, between the ages of 21 and 40 years and married, and five patients waited longer than the recommended time, and Orthopedics/Traumatology was the specialty with greater number of patients attended. Conclusion: it was concluded that the users are satisfied with the Nursing performance in the humanization of care, in the reception and in the classification with risk classification, in emergency medical services. It is inferred that considerations about the theoretical or practical implications of the results and the contribution of the study to the advancement of scientific knowledge are to establish relations between the humanization of care and the reception and sorting with risk classification in emergency medical services. It is hoped to find situations in which there is a lack of humanization and to put them in evidence, proposing changes. Descriptors: Humanization of Care; Reception; Screening; Ranking; Risk; Emergency Nursing. RESUMEN Objetivo: establecer relaciones entre la humanización de la asistencia y la acogida y el tamizaje en la clasificación de riesgo por la enfermería en los servicios médicos de emergencia. Método: se trata de un estudio cuantitativo, analítico, transversal. Se utilizó un cuestionario y se entrevistaron a 80 pacientes que estaban en consulta de enfermería. Se utilizó el análisis descriptivo, promedios, desviación estándar, mediana, mínimo y máximo, frecuencia y porcentual. Se presentaron los resultados en forma de tablas. Resultados: se verificó que, de los 64 pacientes, la mayoría era del sexo femenino, en el grupo de edad entre 21 a 40 años y casada, y cinco pacientes esperaron más que el tiempo preconizado, siendo que la Ortopedia / Traumatología fue la especialidad con mayor el número de pacientes atendidos. Conclusión: se llegó a la conclusión de que los usuarios están satisfechos con la actuación de la Enfermería en la humanización de la asistencia, en la acogida y en el tamizaje con clasificación de riesgo, en los servicios médicos de emergencia. Se espera encontrar situaciones en que hay falta de humanización y ponerlas en evidencia, proponiendo cambios. Descriptores: Humanización de la Atención; Acogimiento; Triagem; Classificación; Risco; Enfermería de Urgencia.

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Epidemiological Characteristics of Traffic and Non-traffic Injuries and Quality of Emergency Medical Services in Southern Thailand

Journal of Health Science and Medical Research ◽

10.31584/jhsmr.2021783 ◽

2021 ◽

Author(s):

Patcharee Prommoon ◽

Thanom Phibalsak ◽

Janya Netwachirakul ◽

Mayuree Mekthat ◽

Walailuk Jitpiboon ◽

...

Keyword(s):

Emergency Medical Services ◽

Motor Vehicle ◽

Care Staff ◽

Medical Services ◽

Health Care Staff ◽

Emergency Medical ◽

Number Of Patients ◽

Southern Thailand ◽

Injured Patients ◽

Epidemiological Characteristics

Objective: This study aimed to report the situation of injuries and emergency medical services in southern Thailand.Material and Methods: Data from the Injury Surveillance system of a Level 1 Trauma Center Hospital in lower southern Thailand during 2012-2016 were extracted. Trends in epidemiological characteristics of both traffic and non-traffic injuries and emergency medical services were described. Logistic regression was used for the analysis.Results: The number of patients admitted to emergency departments due to traffic and non-traffic injuries was stable over the five-year period (n=102, 840). Traffic injuries involving motorcycles and falls were the two leading causes of injury. Most were adults aged 19-60 years (62.5%). The most common risky behaviors were driving a motor vehicle without wearing a seatbelt (81.9%) and riding a motorcycle without wearing a helmet (71.7%). Alcohol and drug use were relatively low but significantly increased the odds of sustaining a severe/critical injury. Significant predictors of severe/ critical non-traffic injury included drowning [odds ratio (OR)=29.7, 95% confidence interval (CI)=11.9-74.7], self-harm/ suicide (OR=12.6, 95% CI=9.2-17.3), and bites/stings from poisonous animals (OR=8.1, 95% CI=6.1-10.8). The use of Emergency Medical Services (EMS) was low but increased over time. The main challenge was delivering appropriate EMS for different levels of injury. The percentage of health care staff who performed advanced life support appropriately for critically injured patients ranged from 95.5% to 100.0% while for severely injured patients, ranged from 93.9% to 100.0%.Conclusion: Traffic and non-traffic injuries were high and the use of EMS was still low in southern Thailand.

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Abstract W P187: Utilization of Emergency Medical Services to Transfer Acute Stroke Patients Directly to Scanning Reduces the Length of Time to Scan Result

Stroke ◽

10.1161/str.45.suppl_1.wp187 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Scott Dunbar ◽

Theresa Hoffecker ◽

Avery Schwenk

Keyword(s):

Acute Stroke ◽

Ct Scan ◽

Emergency Medical Services ◽

Ct Scanning ◽

Medical Services ◽

Time Of Arrival ◽

Stroke Patients ◽

Emergency Medical ◽

Number Of Patients ◽

The Mean

Background: Rapid assessment and treatment of acute stroke patients including computerized tomography (CT) scanning to determine the need for tissue plasminogen activator (tPA) has been shown to be vital to positive patient outcomes. As part of an ongoing effort to reduce door-to-needle time for such patients, the door-to-CT result time was identified as an area that could be reduced by collaborative effort between Emergency Medical Services (EMS) and Emergency Department (ED) staff. We hypothesized that implementing an EMS protocol for direct-to-CT scanning as part of a collaborative stroke alert protocol would reduce overall door-to-CT result time. Methods: Local EMS and ED implemented criteria to alert the ED of acute stroke patients being transported to their facility. This alert included an estimated time of arrival and was sent to radiology, neurology, registration and pharmacy. Upon arrival, the patient was met by ED personnel while still on the EMS gurney. If the ED physician concurred with the field impression of acute stroke, the patient was taken directly to CT scanning by EMS. Data on time of door-to-CT result were collected from 7/9/12 to 7/8/13 and divided into those patients who received a stroke alert from EMS (n=41), and those who did not (n=81). All data are expressed as mean ± standard error. Results: The time for door-to-CT result was reduced (p<0.0001) for patients who received a stroke alert from EMS [16.5 ± 1.2 vs 31.6 ± 1.5 minutes, alert vs no alert, respectively]. Similarly, in the subset of patients who received tPA after the CT scan, the mean time door-to-CT scan results was reduced (p<0.005) in those patients who received a stroke alert from EMS (14.3 ± 1.1 vs 36.4 ± 7.3 minutes, alert vs no alert, respectively). Conclusions: Implementation of a stroke alert including a direct-to-CT protocol by EMS significantly reduced the mean door-to-CT result time in acute stroke patients. Expanding this protocol to include other area EMS services and hospitals could potentially result in a greater number of patients benefiting from these reduced times.

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Abstract TP250: A Substantial Rate of Neurological and Non-Neurological Stroke Mimics Are Transported by Emergency Medical Services for Acute Stroke Evaluation

Stroke ◽

10.1161/str.48.suppl_1.tp250 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Joel N Briard ◽

Rahel T Zewude ◽

Mahesh Kate ◽

Ken Butcher ◽

Laura C Gioia

Keyword(s):

Acute Stroke ◽

Emergency Medical Services ◽

Final Diagnosis ◽

Medical Services ◽

Cross Sectional ◽

Stroke Mimics ◽

Emergency Medical ◽

Number Of Patients ◽

Suspected Stroke ◽

The Impact

Introduction: The impact of prehospital triage of stroke mimics to designated stroke centers may be considerable, yet little information exists regarding stroke mimics in the prehospital setting. We aimed to describe the rate and clinical characteristics of neurological and non-neurological stroke mimics transported by Emergency Medical Services (EMS) to the Emergency Department (ED) for acute stroke evaluation. Methods: A retrospective, cross-sectional, observational analysis of a centralized EMS database of patients transported by EMS to the ED for suspected stroke during an 18-month period. Hospital charts and neuroimaging were utilized to determine the final diagnosis (acute stroke, stroke mimic, as well as specific underlying diagnoses). Results: A total of 960 patients were transported by EMS to the ED with suspected stroke, among whom 405 (42.2%) were stroke mimics (mean age ± SD: 66.9 ± 17.1 years; 54% male). Stroke mimics were neurological in origin in 223 (55.1%) patients and non-neurological in 182 (44.9%). Most common neurological diagnoses were seizures (n=44,19.7%), migraines (n=42,18.8%) and peripheral neuropathies (n=25, 11.2%). Most common non-neurological mimics included cardiovascular (15.9%), psychiatric (11.9%), and infectious (8.9%) diagnoses. Neurological mimics were younger (64.1 ± 17.3 years) than non-neurological mimics (70.5 ± 16.1 years, p<0.001). Median prehospital Glasgow Coma Scale scores were similar between groups (15 vs. 15, p=0.26). Mean prehospital systolic blood pressure was slightly higher in neurological (147.8±24.2 mmHg) than non-neurological mimics (141.2±26.2 mmHg, p=0.01). Conclusions: Stroke mimics represent a substantial number of patients transported by EMS for suspected stroke, with a considerable amount being non-neurological in origin. Prospective prehospital studies are warranted to help refine prehospital identification of acute stroke and thus minimize the number of stroke mimics transported by EMS for acute stroke evaluation.

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Abstract W P186: Usefulness of the New Prehospital Cerebrovascular Disease Triage Score for Patients With Impaired Consciousness by Emergency Medical Services

Stroke ◽

10.1161/str.45.suppl_1.wp186 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

katsufumi kajimoto ◽

Hideaki Kanki ◽

Kazuyuki Nagatsuka

Keyword(s):

Emergency Medical Services ◽

Univariate Analysis ◽

Multivariable Analysis ◽

Vital Signs ◽

Medical Services ◽

Impaired Consciousness ◽

Characteristic Analysis ◽

Emergency Medical ◽

Stroke Group ◽

New Onset

Background and Purpose: Early stroke recognition optimizes patients’ opportunities to benefit from therapeutic options; however, accurate stroke recognition by emergency medical services (EMS) is difficult in patients with impaired consciousness. Here we attempted to establish a new prehospital stroke triage score for such patients. Methods: In 2010, 713 patients (average age, 71 years; 421 men) presenting with impaired consciousness (score of <15 on the Glasgow coma scale) on EMS arrival, who were brought to our hospital, were included. We compared the relation between the symptoms and the vital signs on EMS arrival and the final diagnosis. Results: A final hospital diagnosis of stroke was made for 353 in 713 patients (49.5%). Systolic and diastolic blood pressure (SBP, DBP) on EMS arrival were significantly higher in the stroke group than in the non-stroke group (SBP: 172 mmHg vs 143 mmHg, p < 0.01, DBP: 93 mmHg vs 78 mmHg, p < 0.01). In contrast, the pulse rate (PR) was lower in the stroke group (84 bpm vs 88 bpm, p < 0.05). Receiver operating characteristic analysis showed that the optimum SBP, DBP, and PR cutoffs for stroke were 150 mmHg (sensitivity 76%, specificity 59%), 90 mmHg (63%, 70%), and 90 bpm (70%, 42%), respectively. Using univariate analysis, SBP of >150 mmHg, DBP of >90 mmHg, PR of <90 bpm and an arrhythmia case in addition to new-onset hemiparesis were significantly associated with stroke, whereas a case with cold sweat was not significantly associated. Using multivariable analysis, new onset hemiparesis (Odds ratio 11.0; 95% CI, 5.76-22.7), SBP of >150 mmHg (2.21, 1.26-3.87), DBP of >90 mmHg (2.88, 1.65-5.09), and PR of <90 bpm (2.25, 0.80-3.80) were significantly associated with stroke. The prehospital stroke triage score was calculated for each patient with 1 point assigned to patients with SBP of >150 mmHg, DBP of >90 mmHg, PR of <90 bpm, and 2 points for new onset hemiparesis. The triage score of >2points revealed stroke with relatively high sensitivity and specificity (sensitivity 63%, specificity 87%, AUC = 0.809). Conclusion: The new prehospital stroke triage score was calculated on the basis of vital signs in addition to new onset hemiparesis. This score is very useful for triage of stroke presenting with impaired consciousness.

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Stop Stroke: A Brief Report on Door-to-Needle Times and Performance After Implementing an Acute Care Coordination Medical Application and Implications to Emergency Medical Services

Prehospital and Disaster Medicine ◽

10.1017/s1049023x17000097 ◽

2017 ◽

Vol 32 (3) ◽

pp. 343-347 ◽

Cited By ~ 4

Author(s):

Robert Dickson ◽

Adrian Nedelcut ◽

Melissa McPeek Nedelcut

Keyword(s):

Emergency Medical Services ◽

Acute Care ◽

Care Coordination ◽

Medical Application ◽

Medical Services ◽

Secondary Outcome ◽

Publication Type ◽

Emergency Medical ◽

Number Of Patients ◽

And Performance

AbstractObjectiveThe objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS).MethodsThis was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period. The primary outcome was mean DTN times before and after initiating Stop Stroke. Secondary outcome was the effect on the DTN≤60-minute benchmark.ResultsDuring the study period, there were 533 stroke activations (200 before Stop Stroke implementation and 333 after). A total of 68 patients meeting inclusion criteria were analyzed (34 pre-app and 34 post- app). The observed mean DTN times post-app decreased 21 minutes (77 to 56 minutes), a 28% improvement (P=.001). Further, the patients meeting DTN≤60 minutes improved from 32% (11 of 34) to 82% (28 of 34) after the app’s implementation.ConclusionsIn this cohort of patients with AIS, Stop Stroke improved mean DTN times and number of patients treated within 60 minutes of arrival. These results demonstrate the app’s effect of increasing awareness of suspected AIS and improving coordination of care, evidenced by the magnitude of its effect on treatment times.DicksonR, NedelcutA, McPeek NedelcutM. Stop Stroke: a brief report on door-to-needle times and performance after implementing an acute care coordination medical application and implications to Emergency Medical Services. Prehosp Disaster Med. 2017;32(3):343–347.

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Knowledge of stroke and attitude to activate emergency medical services: a cross-sectional study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.666 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Carrossa ◽

A Favaretto ◽

C De Luca ◽

G Boscaro ◽

D Gregori ◽

...

Keyword(s):

Emergency Medical Services ◽

Online Survey ◽

Signs And Symptoms ◽

Warning Signs ◽

Medical Emergency ◽

Medical Services ◽

Average Score ◽

Cross Sectional ◽

Emergency Medical ◽

Stroke Knowledge

Abstract Introduction Acute brain stroke is one of the leading causes of death in the world. Translating knowledge of stroke warning signs into appropriate actions is critical to decrease prehospital delay, meaning that the population has a key role in reducing the hospitalization time of affected people. Objectives The aim is to understand in which percentage adults (318, without healthcare formation) would react properly by calling emergency medical services (EMS) when presented with hypothetical stroke-related scenarios and how the knowledge of warning signs is related to different factors. Methods a population-based online survey was carried out in a random sample of Italian adults in June-July 2019. The STAT (Stroke Action Test) questionnaire included 21 close-ended questions focused on stroke symptoms. The prevalence and distribution of stroke knowledge was examined. Results 445 subjects were enrolled; the mean age was 36 years. The average score was 10,9/21, and only 21% had an optimal performance. Higher scores are associated with female gender and older age (p < 0,01). When a situation described a single stroke sign, only the 15% recognized the importance to call EMS. The sign/symptom mainly recognized (57%) was “trouble speaking”. Conclusions this study provides data describing stroke knowledge among Italian adults; despite its limitations, the study shows that people hesitate to call EMS when stroke signs and symptoms are presented. The knowledge of stroke signs/symptoms remains lower than the heart attack ones. As expected, it would be 'useful to give proper information and training on stroke signs/symptoms' but also it is fundamental to emphasize that stroke is a medical emergency and needs a fast hospital admission. Key messages There is a lack of knowledge in stroke emergency shall raise community awareness about the need of education campaigns. It is important to improve stroke's signs and symptoms in order to have better prognosis.

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Impact of COVID-19 on Emergency Medical Services for Patients with Acute Stroke Presentation in Busan, South Korea

Journal of Clinical Medicine ◽

10.3390/jcm11010094 ◽

2021 ◽

Vol 11 (1) ◽

pp. 94

Author(s):

Jiyoung Kim ◽

Choongrak Kim ◽

Song Yi Park

Keyword(s):

South Korea ◽

Acute Stroke ◽

Emergency Medical Services ◽

Processing Time ◽

Medical Services ◽

Processing Times ◽

Emergency Medical ◽

Number Of Patients ◽

Comprehensive Stroke Center ◽

The Impact

The purpose of this retrospective observational study was to identify the impact of COVID-19 on emergency medical services (EMS) processing times and transfers to the emergency department (ED) among patients with acute stroke symptoms before and during the COVID-19 pandemic in Busan, South Korea. The total number of patients using EMS for acute stroke symptoms decreased by 8.2% from 1570 in the pre-COVID-19 period to 1441 during the COVID-19 period. The median (interquartile range) EMS processing time was 29.0 (23–37) min in the pre-COVID-19 period and 33.0 (25–41) minutes in the COVID-19 period (p < 0.001). There was a significant decrease in the number of patients transferred to an ED with a comprehensive stroke center (CSC) (6.37%, p < 0.001) and an increase in the number of patients transferred to two EDs nearby (2.77%, p = 0.018; 3.22%, p < 0.001). During the COVID-19 pandemic, EMS processing time increased. The number of patients transferred to ED with CSC was significantly reduced and dispersed. COVID-19 appears to have affected the stroke chain of survival by hindering entry into EDs with stroke centers, the gateway for acute stroke patients.

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