PT  - JOURNAL ARTICLE
AU  - Lauri Laukkanen
AU  - Sanna Lahtinen
AU  - Lasse Raatiniemi
AU  - Ari Ehrola
AU  - Timo Kaakinen
AU  - Janne Liisanantti
TI  - Emergency department admission and mortality of the non-transported emergency medical service patients: a cohort study from Northern Finland
AID  - 10.1136/emermed-2020-209914
DP  - 2021 Apr 20
TA  - Emergency Medicine Journal
PG  - emermed-2020-209914
4099  - http://emj.bmj.com/content/early/2021/04/19/emermed-2020-209914.short
4100  - http://emj.bmj.com/content/early/2021/04/19/emermed-2020-209914.full
AB  - Objectives A high number of emergency medical service (EMS) patients are not transported to hospital by ambulance. Various non-transport protocols and guidelines have been implemented by different EMS providers. The present study examines subsequent tertiary care ED and hospital admission and mortality of the patients assessed and not transported by EMS in Northern Finland and evaluates the factors predicting these outcomes.Methods Data from EMS missions with a registered non-transportation code during 1 January 2018–31 December 2018 were screened retrospectively. EMS charts were retrieved from a local EMS database and data concerning hospital admission and mortality were collected from the medical records of Oulu University Hospital, Oulu, Finland.Results A total of 12 530 EMS non-transport missions were included. Of those, a total of 344 (2.7%) patients were admitted to tertiary care ED in 48 hours after the EMS contact, and 229 (1.8%) of them were further admitted to the hospital. Patients with the dispatch code ‘abdominal pain’, clinical presentation with fever or hyperglycaemia, physician phone consultation and a decision not to transport during night hours were associated with a higher risk of ED admission within 48 hours after EMS contact. Overall 48-hour and 30-day mortalities of non-transported patients were 0.2% (n=25) and 1.0% (n=128), respectively.Conclusion In this cohort, the rate of subsequent tertiary care ED admission and mortality in the non-transported EMS patients was low. Dispatch code abdominal pain, clinical presentation with fever or hyperglycaemia, physician phone consultation and night-hours increased the risk of ED admission within 48 hours after EMS contact.Data are available on reasonable request from the corresponding author and with approval from the administration of Oulu University Hospital.