Declining Use of Pre-Hospital Emergency Medical Services During the COVID-19 Pandemic in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany

Hegenberg, Kathrin; Althammer, Alexander; Gehring, Christian; Prueckner, Stephan; Trentzsch, Heiko

doi:10.2139/ssrn.3924850

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…In emergency transport, an increase in the number of difficult cases and a longer time spent at the scene were noted (4). Similarly, Taiwan and Germany experienced a decline in the number of emergency transport requests (5,6), making it challenging to find suitable facilities for certain cases (7).…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID‑19 infection on emergency obstetric and gynecological transport

Tsuzuki,

Minami,

Nagai

et al. 2024

World Acad Sci J

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The spread of COVID-19 affected emergency medical care worldwide. Studies have observed various impacts of COVID-19, depending on the intensity of infection control measures, the number of medical facilities and the demographic composition of the region. However, reports on the impact on emergency medicine in rural cities or in the field of obstetrics and gynecology are limited. Therefore, the present study examined the impact of COVID-19 infection on the emergency transfer of patients with obstetric and gynecological diseases, where medical resources are limited. A cross-sectional study was conducted using a publicly available database. From 2019 to 2021, there were 635 obstetrics and gynecology transfers, which were divided into obstetric and gynecological diseases. The year 2019 was defined as the pre-pandemic period, while the other 2 years were labeled as the post-pandemic period. The number of transports, post-transportation outcomes and the percentage of transfers and the time required for transport were examined. The number of transfers did not change significantly during the post-pandemic period. In obstetric diseases, the number of transported patients who did not require hospitalization increased, and transfers from primary facilities decreased during the post-pandemic period. There was no change in severity or transport type for gynecological diseases, nor in the time required for transport for both obstetric and gynecological cases. The impact of infectious diseases on emergency transfers for obstetric and gynecological cases was considered low. Whether the increase in COVID-19 cases not requiring hospitalization and the decrease in transfers in obstetrics cases were due to the impact of infectious diseases remains unclear; thus, further studies are required.

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Section: Introductionmentioning

confidence: 99%

Impact of COVID‑19 infection on emergency obstetric and gynecological transport

Tsuzuki,

Minami,

Nagai

et al. 2024

World Acad Sci J

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“…OEMS is provided in dedicated practices, sometimes in close proximity to hospitals, but usually has no laboratory facilities available. In emergency care settings, physicians from various disciplines face patients with a wide range of conditions2–4 and a high workload 5…”

Section: Introductionmentioning

confidence: 99%

Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-hours outpatient emergency medical services

et al. 2023

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ObjectivesOut-of-hours outpatient emergency medical services (OEMS) provide healthcare for patients with non-life-threatening conditions in need for urgent care when outpatient practices are closed. We studied the use of point-of-care-testing of C-reactive protein (CRP-POCT) at OEMS.DesignCross-sectional questionnaire-based survey.SettingSingle centre OEMS practice in Hildesheim, Germany (October 2021 to March 2022).ParticipantsOEMS physicians answering a questionnaire immediately after performing CRP-POCTs (CUBE-S Analyzer, Hitado) on any patients.Primary and secondary outcomesImpact of CRP-POCTs on clinical decision-making and perceived usefulness.ResultsIn the 6-month study period, 114 valid CRP-POCTs were performed in the OEMS practice by 18 physicians and the questionnaire was answered in 112 cases (response rate: 98.2%). CRP-POCTs were used in the diagnosis of inflammatory diseases of the gastrointestinal tract (60.0%), respiratory tract infections (17.0%), urinary tract infections (9.0%) and other non-gastrointestinal/non-specified infections (11.0%). The use of a CRP-POCT resulted in a change of the physicians’ clinical decision in 83.3% of the cases. Specifically, in 13.6% and 35.1% of the cases, rapid CRP measurements led to decision changes in the (1) initiation of antimicrobial therapy and (2) other drug treatment, respectively. Notably, in 60% of all cases, the use of a CRP-POCT reportedly changed the decision on hospitalisation/non-hospitalisation of OEMS patients. In respect of antimicrobial therapy and hospitalisation, these decision changes primarily (≥73%) promoted ‘step-down’ decisions, that is, no antibiotic therapy and no hospital admission. In the great majority of CRP-POCT applications (≥95%), OEMS physicians reported that rapid CRP measurements increased the confidence in their diagnostic and therapeutic decision. In almost all cases (97%), physicians rated the CRP-POCT use as useful in the treatment situation.ConclusionQuantitative CRP-POCT promotes step-down clinical decisions and strengthens the clinical confidence of physicians in out-of-hours OEMS.

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Declining Use of Pre-Hospital Emergency Medical Services During the COVID-19 Pandemic in 2020: Descriptive Study Based on Routinely Collected Dispatch Data in Bavaria, Germany

Cited by 2 publications

References 11 publications

Impact of COVID‑19 infection on emergency obstetric and gynecological transport

Impact of COVID‑19 infection on emergency obstetric and gynecological transport

Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-hours outpatient emergency medical services

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