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04 Improving the prehospital identification and management of people presenting to the ambulance service with COVID 19 symptoms
  1. David Fitzpatrick2,
  2. Matthew Moore1,
  3. Catherine Best1,
  4. Federico Andreis1,
  5. Edward Duncan1,
  6. Martin Esposito2,
  7. Alasdair Corfield3,
  8. Richard Dcobbie4,
  9. David Lowe3
  1. 1University of Stirling, UK
  2. 2Scottish Ambulance Service, UK
  3. 3NHS Greater Glasgow and Clyde, UK
  4. 4Public Health UK


Background Little is known about how patients with COVID-19 present to ambulance services or their outcomes. Between 1st March and 31st August 2020 we investigated individuals who called the Scottish Ambulance Service (SAS) with COVID-19 symptoms and those that were later tested COVID-19 positive. We analysed i) their demographic and clinical characteristics; ii) their disposal; and iii) their admission and mortality outcomes.

Methods SAS and NHS Scotland Health Board data are routinely linked in a national database. These data evidence a patients journey from ambulance call to hospital attendance and subsequent outcome. Evidence of COVID-19 testing was identified 10 days either side of the call.

Results 171,169 patients made 257,207 calls during the study period. Of these, 2.8% (n=7,305) were categorised as possible COVID-19 patients during telephone triage. From the flagged +ve patient calls 6% had a COVID-19 positive result, 29% had a negative COVID-19 result and the other 65% had no evidence of being tested. The majority (54%) were taken to the Emergency Department; 73% received further hospital care. The proportion of patient calls admitted within 10 days of the call was 31% for those not conveyed against 82% for conveyed. Final prehospital physiology for COVID-19 positive patients demonstrated lower oxygen saturations, higher respiratory rates and temperatures. 4.9% and 11.7% of patients conveyed to hospital died within 3 and 30 days vs 5.2% and 19.6% of patients not conveyed respectively.

Conclusions This study suggests telephone triage is not a reliable identifier of COVID-19 patients reinforcing existing requirements for Personal Protective Equipment. 30-day mortality rates differed between those patients initially conveyed vs not conveyed. Clinical characteristics of COVID-19 positive patients suggest they were clinically less well than other patients.

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