Delayed mobilization of the emergency physician in prehospital missions

A retrospective analysis of 118 prehospital missions involving vitally important therapy (anaesthesia or resuscitation with admission) was carried out. Primary mobilization of the emergency physician (EP) (i.e. before arrival of the rescue ambulance) was carried out by the alarm dispatch centre in only 36% of these missions. In the 74 missions utilizing secondary alarm (i.e. request for the EP after the arrival of the ambulance), detrimental delay of 8 minutes or more was found in 30%. In two of the 27 missions of cardiopulmonary resuscitation with subsequent admission, the physician was only mobilized after the patient developed cardiac arrest during unescorted transport although acute myocardial infarction had been suspected prior to transport. The observations suggest that an improved assessment of possible involvement of an EP is necessary, both at the alarm central and the emergency site. Moreover, continued monitoring (quality control) of this delay is necessary.