The following is a summary of “Prehospital COVID-19 patients discharged at the scene – an observational study,” published in the December 2023 issue of Emergency Medicine by Heinonen et al. 

During the COVID-19 pandemic, emergency medical services (EMS) served as the initial point of contact for numerous patients. This study aimed to explore whether the decision of non-conveyance for COVID-19 patients was more frequently linked to a subsequent EMS call than direct ambulance transport to the hospital.

The study encompassed all confirmed COVID-19 patients with an EMS call within 14 days of symptom onset. Patients were categorized based on their prehospital transport decision (transport vs. non-conveyance). The primary endpoint was a new EMS call within 10 days leading to ambulance transport.

A total of 1,286 patients meeting the study criteria were included; among them, 605 (47.0%) were male, with a mean age of 50.5 (standard deviation [SD] 19.3) years. Dyspnea and malaise were the most common dispatch codes, accounting for 51.0% and 28.3% of calls, respectively. High-priority dispatch was utilized in 17.1% of cases. Following prehospital evaluation, 45.6% of patients were discharged at the scene, with 12.4% receiving oxygen, all but one of whom were transported.

A new EMS call leading to ambulance transport occurred in 10.3% of cases, with 30.1% in the primarily transported group and 69.9% among patients initially discharged at the scene (p<.001). No significant differences were noted in past medical history, abnormal vital signs, or total NEWS score. Oxygen supplementation was administered to 24.8% of patients, while 2.3% received other medications.

Nearly half of prehospital COVID-19 patients could be discharged at the scene, and approximately one-sixth of these experienced a subsequent EMS call and ambulance transport within the following 10 days. Patients primarily discharged at the scene did not exhibit significant deterioration, indicating that EMS effectively adapted its approach during the initial pandemic wave to mitigate emergency department overcrowding.

Source: bmcemergmed.biomedcentral.com/articles/10.1186/s12873-023-00915-6