The non-conveyance of trauma patients in Swedish emergency medical services: a retrospective observational study of the trauma population not transported to an emergency department.
BMC Emergency Medicine · 2024-02-27 · Observational study
Abstract
INTRODUCTION: Due to a systemic modification in Swedish emergency medical services (EMS) staffing in recent years, the nature of the Swedish EMS has changed. Transport to an emergency department (ED) is no longer the only option. Referrals and non-conveyance form a growing part of EMS assignments. Trauma is one of the most common causes of death and accounts for 17% of Swedish EMS assignments. The aim of this study was to describe the characteristics and clinical outcomes of non-conveyed trauma patients who were assessed, treated and triaged by the EMS to gain a better understanding of, and to optimise, transport and treatment decisions. METHODS: The study had a descriptive, retrospective and epidemiologic design and was conducted by reviewing EMS and hospital records for 837 non-conveyed trauma patients in the southwest of Sweden in 2019. RESULTS: Three in four non-conveyed trauma patients did not seek further medical care within 72 h following EMS assessment. The patients who were admitted to hospital later were often older, had suffered a fall and had a medical history. Half of all the incidents occurred in a domestic environment, and head trauma was the major complaint. Less than 1% of the studied patients died. CONCLUSION: Most of the non-conveyed trauma patients did not seek further medical care after being discharged at the scene. Falling was the most common trauma event, and for the older population, this meant a higher risk of hospital admission. The reasons for falls should therefore be investigated thoroughly prior to non-conveyance decisions. Future studies should focus on the reasons for non-conveyance and measure the morbidity and invalidity outcomes rather than mortality.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Older adults
Related articles
- Serious conditions among conveyed and non-conveyed patients presenting with nonspecific chief complaints to the ambulance service. (BMC Emerg Med, 2024)
- Outcomes of adult patients discharged at scene by emergency medical services. (Emerg Med J, 2024)
- Decision on non-conveyance of patients suspected of COVID-19 in a novel arrangement with assessment visits by paramedics at home. (BMC Emerg Med, 2023)
- Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians: a cohort analysis. (BMC Emerg Med, 2021)
- EMS non-conveyance: A safe practice to decrease ED crowding or a threat to patient safety? (BMC Emerg Med, 2021)
- Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: a prospective observational study. (BMC Emerg Med, 2020)