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The non-conveyance of trauma patients in Swedish emergency medical services: a retrospective observational study of the trauma population not transported to an emergency department
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden; PICTA, Prehospital Innovation arena, Lindholmen Science Park, Gothenburg, Sweden. (PreHospen)
Faculty of Caring Science, Work Life and Social Welfare, University of Borås. (PreHospen)
Faculty of Health and Society, Department of Care Science, Malmö University. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
2024 (English)In: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 34Article in journal (Refereed) Published
Abstract [en]

Introduction

Due to a systemic modification in Swedish emergency medical services (EMS) staffing in recent years, the nature of the Swedish EMS has changed. Transport to an emergency department (ED) is no longer the only option. Referrals and non-conveyance form a growing part of EMS assignments. Trauma is one of the most common causes of death and accounts for 17% of Swedish EMS assignments. The aim of this study was to describe the characteristics and clinical outcomes of non-conveyed trauma patients who were assessed, treated and triaged by the EMS to gain a better understanding of, and to optimise, transport and treatment decisions.

Methods

The study had a descriptive, retrospective and epidemiologic design and was conducted by reviewing EMS and hospital records for 837 non-conveyed trauma patients in the southwest of Sweden in 2019.

Results

Three in four non-conveyed trauma patients did not seek further medical care within 72 h following EMS assessment. The patients who were admitted to hospital later were often older, had suffered a fall and had a medical history. Half of all the incidents occurred in a domestic environment, and head trauma was the major complaint. Less than 1% of the studied patients died.

Conclusion

Most of the non-conveyed trauma patients did not seek further medical care after being discharged at the scene. Falling was the most common trauma event, and for the older population, this meant a higher risk of hospital admission. The reasons for falls should therefore be investigated thoroughly prior to non-conveyance decisions. Future studies should focus on the reasons for non-conveyance and measure the morbidity and invalidity outcomes rather than mortality.

Place, publisher, year, edition, pages
2024. Vol. 34
Keywords [en]
Emergency medical services, Triage, Non-conveyance, Trauma patient, Ambulance
National Category
Nursing
Identifiers
URN: urn:nbn:se:hb:diva-31633DOI: 10.1186/s12873-024-00952-9ISI: 001174243500004Scopus ID: 2-s2.0-85186177877OAI: oai:DiVA.org:hb-31633DiVA, id: diva2:1841116
Available from: 2024-02-27 Created: 2024-02-27 Last updated: 2024-10-01Bibliographically approved

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Publisher's full textScopushttps://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-00952-9

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Larsson, GlennAndersson Hagiwara, Magnus

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