Descriptive Analysis Of Mental Health-Related Presentations To Emergency Medical Services

Roggenkamp, Renee; Andrew, Emily; Nehme, Ziad; Cox, Sue

doi:10.1080/10903127.2017.1399181

Cited by 51 publications

(77 citation statements)

References 12 publications

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“…Not surprisingly, no disease (A97) was a common code in the non-conveyance group, as was acute alcohol abuse (P16), as was found earlier in Finland [6]. Our study showed that patients in the conveyed group were more likely to suffer mental problems (P29), which is the same result as in previous studies [41,42]. This is surprising, because one study found that psychiatric patients rarely need any treatment [36].…”

Section: Discussionsupporting

confidence: 81%

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Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

Paulin

Kurola

Salanterä

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Emergency Medical Services (EMS) and Emergency Departments (ED) have seen increasing attendance rates in the last decades. Currently, EMS are increasingly assessing and treating patients without the need to convey patients to health care facility. The aim of this study was to describe and compare the patient casemix between conveyed and non-conveyed patients and to analyze factors related to non-conveyance decision making. Methods: This was a prospective study design of EMS patients in Finland, and data was collected between 1st June and 30th November 2018. Adjusted ICPC2-classification was used as the reason for care. NEWS2-points were collected and analyzed both statistically and with a semi-supervised information extraction method. EMS patients' geographic location and distance to health care facilities were analyzed by urban-rural classification. Results: Of the EMS patients (40,263), 59.8% were over 65 years of age and 46.0% of the patients had zero NEWS2 points. The most common ICPC2 code was weakness/tiredness, general (A04), as seen in 13.5% of all patients. When comparing patients between the non-conveyance and conveyance group, a total of 35,454 EMS patients met the inclusion criteria and 14,874 patients (42.0%) were not conveyed to health care facilities. According the multivariable logistic regression model, the non-conveyance decision was more likely made by ALS units, when the EMS arrival time was in the evening or night and when the distance to the health care facility was 21-40 km. Furthermore, younger patients, female gender, whether the patient had used alcohol and a rural area were also related to the non-conveyance decision. If the patient's NEWS2 score increased by one or two points, the likelihood of conveyance increased. When there was less than 1 h to complete a shift, this did not associate with either nonconveyance or conveyance decisions. Conclusions: The role of EMS might be changing. This warrants to redesign the chain-of-survival in EMS to include not only high-risk patient groups but also non-critical and general acute patients with non-specific reasons for care. Assessment and on-scene treatment without conveyance can be called the "stretched arm of the emergency department", but should be planned carefully to ensure patient safety.

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Section: Discussionsupporting

confidence: 81%

“…This is surprising, because one study found that psychiatric patients rarely need any treatment [36]. On the other hand, there is evidence that EMS units often lack the skills required to manage these patients [41]. However, another study found a contrary result, i.e.…”

Section: Discussionmentioning

confidence: 99%

Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

Paulin

Kurola

Salanterä

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Overall, our findings reiterate broader calls for improving the quality of ambulance care for people presenting with mental health and/or AOD issues . A range of measures could be included to achieve this, including an educational approach to address potential skills gaps around communication.…”

Section: Discussionsupporting

confidence: 63%

“…Indeed, paramedics report that attending mental health and/or AOD presentations comprises a significant proportion of their workload . Australian studies have shown that between 10% and 20% of ambulance presentations are related to mental health and/or AOD concerns . Similar to stigmatizing attitudes documented in the general population and amongst some health professional groups, research indicates that some paramedics display negative attitudes towards people who present with mental health and/or AOD problems .…”

Section: Introductionmentioning

confidence: 99%

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

Ferguson

Savic

McCann

et al. 2019

Health Expectations

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Background A large proportion of ambulance callouts are for men with mental health and/or alcohol and other drug (AOD) problems, but little is known about their experiences of care. This study aimed to describe men's experiences of ambulance care for mental health and/or AOD problems, and factors that influence their care. Methods Interviews were undertaken with 30 men who used an ambulance service for mental health and/or AOD problems in Australia. Interviews were analysed using the Framework approach to thematic analysis. Results Three interconnected themes were abstracted from the data: (a) professionalism and compassion, (b) communication and (c) handover to emergency department staff. Positive experiences often involved paramedics communicating effectively and conveying compassion throughout the episode of care. Conversely, negative experiences often involved a perceived lack of professionalism, and poor communication, especially at handover to emergency department staff. Conclusion Increased training and organizational measures may be needed to enhance paramedics' communication when providing care to men with mental health and/or AOD problems.

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“…Australian studies with age‐breakdowns have been undertaken at state level, particularly Victoria and NSW . Nationally, ED data by age group using a narrow definition of MH diagnoses (ICD‐10‐AM F00 to F99 as the primary diagnosis, MH dx ), have been reported annually by the Australian Institute of Health and Welfare (AIHW) for 2004–05 to 2016–17, but no trends have been assessed.…”

Section: Introductionmentioning

confidence: 99%

Trends of emergency department presentations with a mental health diagnosis by age, Australia, 2004–05 to 2016–17: A secondary data analysis

Tran

Lambeth

Sanderson

et al. 2019

Emerg Medicine Australasia

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Objectives: The present study aims to explore for Australia: (i) the trends of ED presentations with a mental health (MH) diagnosis by age group; and (ii) whether those trends differ from all ED presentations. Methods: ED presentations to Australian public hospitals, 2004-05 to 2016-17 were captured in the National Non-Admitted Patient Emergency Department Care Database. We assessed total change and annual rate of change in the number and rates of presentations per 10 000 population for all presentations and those with a MH principal diagnosis (ICD-10-AM F00 to F99, MH dx ). Multivariable regression was used to assess the trend of the proportion of MH dx presentations. Results: Between 2004-05 and 2016-17, children (0-14 years), followed by older persons (≥65 years) had the highest ED utilisation; while youth (15-24 years) and younger adults (25-34 years) predominated for MH dx overlook the growing impact of these sub-groups.

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Descriptive Analysis Of Mental Health-Related Presentations To Emergency Medical Services

Abstract: Mental health-related cases represent one in ten EMS attendances in Victoria. A large proportion of mental health presentations receive little intervention by EMS, and could benefit from community-based services provided by mental health clinicians.

Cited by 51 publications

References 12 publications

Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

Changing role of EMS –analyses of non-conveyed and conveyed patients in Finland

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

Trends of emergency department presentations with a mental health diagnosis by age, Australia, 2004–05 to 2016–17: A secondary data analysis

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