Do the patients referred to the emergency department really deserve an urgent medical intervention?

Aim: In this study, it was aimed to evaluate the urgency of the patients considering their referral complaints indicated by 112 ambulance service crew and their anamnesis obtained in the emergency department (ED) as well. The evaluation was performed according to the World Health Organization (WHO) - 32 - Emergency Parameters (EP).Material and Methods:This retrospective study was carried out examining the data of all patients brought to our hospital’s ED by the 112-ambulance service between the dates January 05, 2017 and October 31, 2017. Qualitative and quantitative evaluations are based on the WHO-32-EP.Results: Findings: The age of the emergency patients was found to be statistically higher than that of non-emergency patients (p= 0.024). It was observed that 171 patients evaluated according to their referral complaints were not in an urgent condition and that 109 patients evaluated according to their anamnesis obtained in the ED were not in an urgent condition as well. When the relationship between the complaints of the patients at the moment of the referral to the ED by 112 ambulance crew, and their anamnesis obtained in the ED, it was found that 24.6% (n = 99) of these patients were not in an urgent condition. Most of the complaints reported by 112 ambulance crew were not found in the WHO-32-EP (n=170).Conclusion: Awareness-raising training may be useful for 112 ambulance service crews that provide on-site emergency medical care so that they can make accurate decisions about diagnosis and perform accurate initial intervention as well.

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1. Hamilton C, Barnett L, Trop A, et al. Emergency department management of patients with rib fracture based on a clinical practice guideline. Trauma Surg Acute Care Open 2017;2:e000133.
2. Holmes JF, Freilich J, Taylor SL, et al. Electronic alerts for triage protocol compliance among emergency department triage nurses: a randomized controlled trial. Nurs Res 2015;64: 226-30.
3. Balikuddembe JK, Ardalan A, Khorasani-Zavareh D, et al. Weaknesses and capacities affecting the Prehospital emergency care for victims of road traffic incidents in the greater Kampala metropolitan area: a cross-sectional study. BMC Emerg Med 2017;17:29.
4. Patel S, Koku Awoonor-Williams J, Asuru R, et al. Benefits and Limitations of a Community-Engaged Emergency Referral System in a Remote, Impoverished Setting of Northern Ghana. Glob Health Sci Pract 2016;4:552-67.
5. Eiset AH, Erlandsen M, Møllekær AB, et al. A generic method for evaluating crowding in the emergency department. BMC Emerg Med 2016;16:21.
6. Pallin DJ, Espinola JA, Camargo CA Jr. US population aging and demand for inpatient services. J Hosp Med 2014;9:193-6.
7. Chow JL, Niedzwiecki MJ, Hsia RY. Trends in the supply of California’s emergency departments and inpatient services, 2005-2014: a retrospective analysis. BMJ Open 2017;7:e014721.
8. Ertan C, Akgün FS, Yücel N. Evaluation of patient transfers to the emergency department of a university hospital. Turk J Emerg Med 2010;10:65-70.
9. Mierendorf SM, Gidvani V. Palliative care in the emergency department. Perm J 2014 18:77-85.
10. Veronese G, Marchesini G, Forlani G, et al. Costs associated with emergency care and hospitalization for severe hypoglycemia. Nutr Metab Cardiovasc Dis 2016;26:345-51.
11. Soyuk S, Arslan S, Kurtulus SA. The Evaluation of The Problems’ Emergency Services From Staff Perspectives. GÜSBD 2017;6:44-56.
12. Kockanat S. The distribution of emergency service patients according to the World Health Organization. J Clin Anal Med 2017;8:474-7.
13. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159-74.
14. Yaylaci S, Ozturk TC, Yılmazer SC. Retrospective evaluation of the urgency of patients admitted the emergency department by ambulance. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2013;4:64-7.
15. Atilla ÖD, Oray D, Akın Ş, et al. An Emergency Department perspec-tive: Ambulance transfers and referral consents of the patients. Turk J Emerg Med 2010;10:175-80.
16. Kıdak L, Keskinoglu P, Sofuoglu T, et al. The evaluation of 112 emergency ambulance service uses in İzmir. Genel Tıp Dergisi 2009;19:113-9.
17. Celik GK, Karakayali O, Temrel AT, et al. Evaluation of Patients Transported to the Emergency Department by 112. Turk Med J 2012;6:73-6.