Time Analysis in Emergency Medical Service Reporting Unit

Aim. The aim of this paper was to determine whether there are any differences in the time of mobilisation and response time of the emergency medical service (EMS) team with respect to the location of the emergency call. Methods. The data for this paper was collected and analysed in detail using the program “e-hitna” (“e-emergency”). The sample consists of all calls received in the period between 1 January and 31 December 2019 in the Medical Reporting Unit of the Department of Emergency Medicine of Zagreb County (DEMZC; Zavod za hitnu medicinu zagrebačke županije). This paper presents the number, category, place of intervention, time of mobilisation of the emergency medical service team, and the response time of the emergency services team to emergency calls designated as priority 1 (A). Results. A total of 47,060 calls were recorded in the “e-hitna” system. We found that out of the total number of calls received, 49% (23,235) were related to emergency interventions. In 38% (8,841) of calls, the medical dispatcher opted for priority 1 (A). According to the place of emergency, 53% (4,691) of priority 1 (A) cases take place in the apartment, while 46% (4,071) occur in a public place. The average mobilisation time of an EMS team for priority 1 (A) cases for apartments is 1.87 ± 1.27, while for public places it is 1.92 ± 0.78 min. (Mann Whitney U test, p<0.001). The average response time of an EMS team for priority 1 (A) cases for apartments is 11.02 ± 4.27, and for public places it is 6.57 ± 3.78 min. The response time was on average much shorter for calls related to emergencies in public places (Mann Whitney U test, p<0,001). Conclusion. The collected data showed that the Department of Emergency Medicine of the Zagreb County effectively aligns their working processes as well as resources with the needs of the population regarding emergency medical care. Creativity, imagination, and constant time analysis are the determinants of the work of a medical dispatcher.

Crowbar impalement: the PHEM perspective

A man in his 50s suffered an impalement on a crowbar after falling from the roof of a domestic shed. A helicopter-based prehospital emergency medical service team was called to assist in the patient’s care. The crowbar had entered from the left-upper quadrant and was tenting the skin of the right iliac fossa. Analgesia and prehospital sedation were provided to facilitate extrication. A series of improvisations were carried out to support the logistics of transferring the patient using an air ambulance to the regional major trauma centre with the crowbar in situ. The patient was taken to the operating theatre without any imaging and a section of perforated bowel was removed. He made a full recovery and was discharged home 9 days postincident.