Small rural emergency services still manage acutely unwell patients: a cross-sectional study

Examine the range of clinical situations encountered at small rural emergency care services. We hypothesised that over a 12 month period, small rural emergency services would encounter almost the entire range of clinical situations described at designated EDs.

We undertook a cross-sectional prospective study observing five small rural emergency care services in South West Victoria. Patients were included if they presented between 1 February 2011 and 31 January 2012, and their type of visit was recorded as an emergency presentation. Main outcome measures are reports that describe clinical activity using the Victorian Emergency Minimum Dataset data collected at the five facilities.

There were 14 318 emergency presentations to the five emergency care services over 1 year. Almost 6% of patients (5.94%, 851/14 318, 95% CI 5.6-6.3%) were in the two most urgent categories. With a wide spectrum of problems presented, the level 1 facility saw 18 of the possible 27 diagnostic categories, and the level 2 and 3 facilities both saw 25 out of 27 diagnostic categories. There were 26 586 procedures recorded. Of the 62 possible medical procedures, only seven were not performed at least once. Critical care procedures were performed in levels 2 and 3 facilities.

The five small rural emergency facilities encountered most of the clinical problems seen in full EDs. They saw almost all categories of emergency presentation, saw almost all diagnostic categories, treated critically ill and injured patients, and performed most procedures.