Interdisciplinary Emergency Care System in a Medium Sized City: Evaluation of 3,997 Cases Over a Four Year Period

Abstract

In 1978 an emergency medical system was established to provide extensive, on the spot treatment for medical emergencies and traffic accidents in Miinster. It was designed, like other systems (17,21,23,25,31,34) to treat all types of medical emergencies, although it was initially thought that victims of traffic accidents would predominate. The system covers the city of Miinster, which is the capital of Westphalia (see Figure 1) and has a population of 270,000 plus its neighboring communities. Thus, the service provides for 300,000 people over a 20 mile circle in diameter. This area has a low percentage of blue collar workers due to a lack of industry, as Miinster is mainly an academic, administrative and business center.A rendezvous system was created where a physician and a specially trained driver/emergency technician (ET) are met at the site of the emergency by two other emergency technicians with a fully equipped ambulance (according to the national German standard DIN 75080 for advanced life support systems). The technical staff and equipment is provided by the local fire brigade. It is here where the emergency calls are received and the alarm is initiated. A triage type questionnaire (Figure 2) helps to define the nature of the emergency and whether an alarm is actually necessary. Three departments of the University Hospital (internal medicine and surgery together with anesthesiology) alternate in the daily 24 hour provision of the physician and the technicians work on a 24 hour shift basis. An evaluation sheet is completed after every run which includes information of the degree of consciousness, respiratory, cardiovascular and physical status, type of emergency, therapeutic measures, final results etc. (Figure 3).For this study all cases (n=3997) from 1980-83 were evaluated using SPSSX (Statistical Package for