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Prehospital mortality in an EMS system using medical priority dispatching: a community based cohort study
Markku Kuisma1, Peter Holmström, Jukka Repo
1Helsinki EMS, Helsinki University Hospital, P.O. Box 112, FIN-00099 Helsingin Kaupunki, Finland. markku.kuisma@hel.fi
Resuscitation
|June 3, 2004
Summary
Faster ambulance response could prevent about one-third of deaths in lower urgency medical priority categories C and D. However, this would significantly increase emergency calls requiring lights and sirens.
Area of Science:
- Emergency medicine
- Public health
Background:
- Prehospital death rates vary significantly across medical priority categories.
- Understanding the impact of ambulance response times on mortality is crucial for optimizing emergency medical services (EMS).
Purpose of the Study:
- To record prehospital death rates in four medical priority categories (A, B, C, D).
- To evaluate if deaths in lower urgency categories (C and D) could be avoided by faster ambulance response.
Main Methods:
- Community-based cohort study in Helsinki, Finland (1999-2002).
- Included 151,928 ambulance calls, excluding interhospital transfers.
- Assessed prehospital mortality and avoidability of deaths by a rapid (≤8 min) ambulance response using an expert panel.
Main Results:
- Prehospital death rates per 1000 calls were 52.0 (A), 11.4 (B), 1.0 (C), and 0.3 (D).
- Expert panel found 1.3% of category C deaths and 0% of category D deaths were avoidable by rapid response.
- 32.9% of category C deaths and 62.5% of category D deaths were potentially avoidable.
Conclusions:
- Medical priority dispatching is linked to low prehospital mortality in lower urgency categories.
- Approximately one-third of deaths in categories C and D might be preventable with faster ambulance response.
- A faster response would likely triple the number of emergency calls requiring lights and sirens.