Abstract
BackgroundThe 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.MethodsUse 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.ResultsWe 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.ConclusionRoutine 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.
Highlights
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
A similar evolution was observed for PEMS interventions during that period, with a rate per 1000 inhabitants increasing from 34 to 39 (Table 1)
Most frequent reasons for the intervention were related to medical problems, with a predominance of unconsciousness, chest pain, respiratory distress or cardiac arrest situations, whereas severe trauma interventions decreased over time
Summary
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. A three-fold increase in the number of calls to PEMS was observed in Paris over 10 years [3], with a two-fold increase in hospital emergency admissions, inducing longer waiting times in both services. There is an important medical, policy, and public health interest to analyze the activity and trends of the whole PEMS concept, including the emergency call center, the pre-hospital emergency ambulances and physicians’ response, as well as the admission of the patients into the hospital emergency network [22]
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