Akuttmedisinske hendingar i ein utkantkommune

Rørtveit, Sverre; Hunskår, Steinar

doi:10.4045/tidsskr.08.0019

Cited by 15 publications

(22 citation statements)

References 2 publications

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“…No special requirements or mandatory training currently exist in Norway for GPs working in casualty clinics. Previous studies have shown that GPs may be exposed to several different emergency situations, but some of them rarely [14]. A paper from 2009 investigating emergency medicine in a rural community suggested mandatory training on a regular basis for GPs taking part in out-of-hours work, supporting the view of our informants [7].…”

Section: Discussionsupporting

confidence: 71%

“…One reason might be that the GPs are often preoccupied with other patients. Several studies have found that the “red response” patients are seldom in a life threatening situation when first examined by the EMT or physician [13],[14]. If it was possible to develop some more specific guidelines for when the EMCC alerts the doctor, this may improve the GP response rate and possibly increase precision in getting them to respond to the “right” cases.…”

Section: Discussionmentioning

confidence: 99%

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The role of general practitioners in the pre hospital setting, as experienced by emergency medicine technicians: a qualitative study

Hjortdahl

Zakariassen

Wisborg

2014

Scand J Trauma Resusc Emerg Med

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BackgroundTogether with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The purpose of the present study was to gain better insight into the EMT’s experiences with the role of the GPs in the care for critically ill patients in the pre-hospital setting.MethodsWe conducted four focus group interviews with EMTs at four different ambulance stations in Norway. Three of the stations were located at least 2 hours driving distance from the nearest hospital. The interviews were transcribed and analyzed using systematic text condensation.ResultsThe EMTs described increasing confidence in emergency medicine during the last few years. However, they felt the need for GP participation in the ambulance when responding to a critically ill patient. The presence of GPs made the EMTs feel more confident, especially in unclear and difficult cases that did not fit into EMT guidelines. The main contributions of the GPs were described as diagnosis and decision-making. Bringing the physician to the patient shortened transportation time to the hospital and important medication could be started earlier. Several examples of sub-optimal treatment in the absence of the GP were given. The EMTs described discomfort with GPs not responding to the calls. They also experienced GPs responding to calls that did not function in the pre-hospital emergency setting. The EMTs reported a need for professional requirements for GPs taking part in out-of-hours work and mandatory interdisciplinary training on a regular basis.ConclusionsEMTs want GPs to be present in challenging pre-hospital emergency settings. The presence of GPs is perceived as improving patient care. However, professional requirements are needed for GPs taking part in out-of-hours work, and the informants suggested a formalized area for training between EMTs and GPs on call.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

The role of general practitioners in the pre hospital setting, as experienced by emergency medicine technicians: a qualitative study

Hjortdahl

Zakariassen

Wisborg

2014

Scand J Trauma Resusc Emerg Med

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“…For instance, cardiovascular problems were most common with 32%, respiratory diseases 11% and psychiatric problems constituted 5% of the situations [7]. Accidents accounted for 16% of the situations [7] which is higher percentage than in our study where accidents accounted for 11%.…”

Section: Discussioncontrasting

confidence: 55%

The epidemiology of medical emergency contacts outside hospitals in Norway - a prospective population based study

Zakariassen

Burman

Hunskaar

2010

Scand J Trauma Resusc Emerg Med

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IntroductionThere is a lack of epidemiological knowledge on medical emergencies outside hospitals in Norway. The aim of the present study was to obtain representative data on the epidemiology of medical emergencies classified as "red responses" in Norway.MethodThree emergency medical dispatch centres (EMCCs) were chosen as catchment areas, covering 816 000 inhabitants. During a three month period in 2007 the EMCCs gathered information on every situation that was triaged as a red response, according to The Norwegian Index of Medical Emergencies (Index). Records from ground ambulances, air ambulances, and the primary care doctors were subsequently collected. International Classification of Primary Care - 2 symptom codes (ICPC-2) and The National Committee on Aeronautics (NACA) Score System were given retrospectively.ResultsTotal incidence of red response situations was 5 105 during the three month period. 394 patients were involved in 138 accidents, and 181 situations were without patients, resulting in a total of 5 180 patients. The patients' age ranged from 0 to 107 years, with a median age of 57, and 55% were male. 90% of the red responses were medical problems with a large variation of symptoms, the remainder being accidents. 70% of the patients were in a non-life-threatening situation. Within the accident group, males accounted for 61%, and 35% were aged between 10 and 29 years, with a median age of 37 years. Few of the 39 chapters in the Index were used, A10 "Chest pain" was the most common one (22% of all situations). ICPC-2 symptom codes showed that cardiovascular, syncope/coma, respiratory and neurological problems were most common. 50% of all patients in a sever situation (NACA score 4-7) were > 70 years of age.ConclusionsThe results show that emergency medicine based on 816 000 Norwegians mainly consists of medical problems, where the majority of the patients have a non-life-threatening situation. More focus on the emergency system outside hospitals, including triage and dispatch, and how to best deal with "everyday" emergency problems is needed to secure knowledge based decisions for the future organization of the emergency system.

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“…tekstboks 10.3. Studien ble gjort i Austevoll kommune der det i studieperioden var omlag 4400 innbyggere, og der det er tradisjon for at kommunens leger involveres i alle tilfeller av sykdom og skade (Rørtveit & Hunskår, 2009). Studien samlet informasjon om alle akutte tilfeller som ble meldt inn til AMK, legevaktsentral, legevaktlege og fastleger, og gir dermed den mest omfattende registrering som er foretatt av akutt sykdom og skade i befolkningen i en kommune.…”

Section: Omfang Av øYeblikkelig Hjelpunclassified

“…Nklms kontaktrater kan tyde på et aktivitetsnivå som er om lag 13 ganger høyere enn det omfanget av akuttmedisinske hendelser som ble funnet i Rørtveit & Hunskår (2009). Dataene er ikke direkte sammenlignbare, siden Austevollstudien registrerte fra hele døgnet og fra alle kontaktpunkter, ikke bare legevakt, men gir likevel en pekepinn på legevakttjenestens volum i forhold til forekomsten av akutt skade og sykdom.…”

Section: Hastegrad Og Alvorlighetunclassified