[Emergency call and medical missions. A six-months' prospective clinical system analysis of the Mannheim area]

The prehospital care of emergency patients has proved to be highly efficient for traumatic and coronary care cases. The critical factor for the rescue mission is the quality of the alarming information. In a prospective 6-month study with two mobile rescue units, all rescue missions were documented in a computerized form. Times for arrival and activities, times for return, type of alarming information, type of emergency, difference between primary and final diagnosis, cases of under- and overestimation of the primary diagnosis, and outcome of external cardiopulmonary resuscitations were listed. A guiding list including medical emergency symptoms and general emergency situations for assistance in deciding to alarm the rescue unit proved to be valid. Of a total of 2151 missions, 88.7% were primary rescue missions, 10.3% failed operations, and 1% secondary missions. The timetable and frequency of operations are shown in Figs. 1 and 2. In 34% of cases simultaneous emergency calls for two different places were received. The spectrum of 1908 missions included 34.8% internal medicine, 24.7% surgery, 14% intoxication, 12% neurological/psychiatric disease, 7.5% cardiopulmonary resuscitation, 4.6% others, and 2.7% primary death (Fig. 3). In 77.6% the primary diagnosis was confirmed by the clinician. Intoxication and epilepsy were overestimated at primary diagnosis, whereas myocardial infarction were underestimated in view of further clinical development. Only in 37.6% of patients reported to be unconscious could the unconsciousness be confirmed. Of 110 patients with prehospital cardiac arrest, 38% could be resuscitated with success; 5.5% of the total could leave the hospital (Fig. 5).(ABSTRACT TRUNCATED AT 250 WORDS)