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Pre‐hospital critical care by anaesthesiologist‐staffed pre‐hospital services in S candinavia: a prospective population‐based study
Author(s) -
KRÜGER A. J.,
LOSSIUS H. M.,
MIKKELSEN S.,
KUROLA J.,
CASTRÉN M.,
SKOGVOLL E.
Publication year - 2013
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12181
Subject(s) - medicine , incidence (geometry) , population , vital signs , emergency medicine , emergency medical services , prospective cohort study , etiology , medical emergency , pediatrics , surgery , physics , environmental health , optics
Background All S candinavian countries provide anaesthesiologist‐staffed pre‐hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist‐staffed pre‐hospital services in S candinavia with special emphasis on incidence and severity. Methods This population‐based, prospective study recorded activity in 16 anaesthesiologist‐staffed pre‐hospital services in D enmark, F inland, N orway and S weden serving half of the S candinavian population. We calculated population incidence of medical conditions, and the proportion of patients with severely deranged vital signs and/or receiving advanced therapy. Results Four thousand two hundred thirty‐six alarm calls were recorded during 4 weeks. Two thousand two hundred fity‐six alarms resulted in a patient encounter. The population incidence varied from 74.9 missions per 10,000 person‐years ( D enmark), followed by F inland with 14.6, N orway with 11, and S weden with 5. Medical aetiology was most frequent (14.9 missions per 10,000 person‐years, 95% CI : 14.2–15.8). Trauma was second (5.6 missions per 10,000 person‐years, 95% CI : 5.12–6.09). Twenty‐three per cent of patients had severely deranged vital functions, and advanced emergency medical procedures were performed in every four to twelve encounters ( D enmark 8%, S weden 15%, N orway 23%, and F inland 25%). The probability that the patient was physiologically deranged, received advanced medication, or procedure was 35%. Critical illness or injury occured at a rate of 25–30 per 10,000 person‐years. Conclusions The incidence of pre‐hospital anaesthesiologist patient encounters in S candinavia varies. Medical aetiology is most frequent. Almost one‐quarter of patients presents with deranged vital functions requiring emergency measures. The S candinavian pre‐hospital population incidence of critical illness and injury is 25–30 per 10,000 person‐years.