Isolated emergency medical incidents in the practice of Polish firefighters in 2020-2023: analysis of intervention causes.
Frontiers in public health · 2025-01-01 · Registry study
Abstract
OBJECTIVE: To quantify and characterize Isolated Emergency Medical Incidents (IEMIs) managed by National Firefighting and Rescue System (NFRS) units in Poland in 2020-2023 and to identify temporal and regional patterns. MATERIALS AND METHODS: Retrospective nationwide analysis of anonymised State Fire Service decision-support records. Inclusion required NFRS arrival before EMS, documented direct actions, duration over 1 min, and dates 01.01.2020-31.12.2023. Descriptive statistics were compiled at the voivodeship level. Group differences were tested with Kruskal-Wallis and Dunn-Bonferroni procedures. Associations were examined with Spearman correlation. Visualizations included heat maps, box plots, and a choropleth. Seasonality was assessed by calendar quarter. RESULTS: Approximately 2.25 million interventions were undertaken; medical rescue comprised about 35%. Regional heterogeneity was significant (χ2 = 46.72; p < 0.001). Mean IEMI duration differed by year (χ2 = 28.35; p < 0.001), peaking in 2021 and declining in 2022-2023 (medians 13-12 min). Pairwise contrasts showed 2020 > 2022 (p = 0.015), 2020 > 2023 (p = 0.001), 2021 > 2022 (p = 0.001), and 2021 > 2023 (p < 0.001). Minimum time did not correlate with the mean (ρ = 0.05; p = 0.7); maximum time did (ρ = 0.55; p < 0.001). Incident counts correlated with population (ρ = 0.518) and urbanization (ρ = 0.446), modestly with number of EMS teams (ρ = 0.396), and weakly with area (ρ = 0.277). Q4 increases were consistent for cardiac arrest, unconsciousness, and dyspnoea; hemorrhage, choking, psychiatric disorders, and other showed no seasonality. Annual totals did not differ (H(3) = 1.83; p = 0.608). CONCLUSION: IEMIs form a stable share of NFRS activity, dominated by cardiac arrest, syncope, trauma, and neurological disorders, with a Q4 peak. Seasonal readiness in October-December, targeted QFA training on CPR/AED, resource allocation by per capita and urbanization metrics, early activation thresholds, standardized winter workflows, and quarterly quality monitoring may improve timeliness and reduce demand.