Breuer F, Pommerenke C, Ziemen B, Stiepak JK, Poloczek S, Dahmen J. [Introduction of emergency paramedic investigators in the context of the COVID-19 pandemic in the Berlin emergency medical service].
Notf Rett Med 2020;
24:1033-1042. [PMID:
33013194 PMCID:
PMC7521198 DOI:
10.1007/s10049-020-00786-5]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND
It has been shown throughout the COVID-19 pandemic that the condition of a number of patients deteriorates acutely when not monitored. This is set against an increased demand for emergency medical services and the resulting scarcity of resources, which makes it necessary to prioritise inpatient treatment or ensure that patients are provided with appropriate outpatient care. In this context, the Berlin Fire Department has introduced emergency paramedic investigators (NotSan-Erkunder) as an additional operating resource.
METHODOLOGY
We assessed all operations from 28.03.2020 to 28.04.2020 during which Emergency Paramedic Investigators of the Berlin emergency services were deployed. A total of 341 operations were included from the 31 days. Alongside data from the dispatch system, all operational documentation was assessed.
RESULTS
In 57% of cases, mNACA II patients (outpatient treatment) were identified, in 42% of cases, mNACA III patients (inpatient treatment) were identified, and in 1% of cases, mNACA IV (imminent danger to life) patients were identified. In 51% of cases, the emergency services transported the patient to a hospital, and in 49%, alternative care measures were employed. These included referral to a local physician in 28% of cases. In 11% of cases, patients were referred to on-call services of the Association of Statutory Health Insurance Physicians (KV in German). In 4% of cases, the Berlin Fire Department emergency dispatch center deployed a physician of the KV (KV-ARE investigator).
DISCUSSION
The results show that additional operational resources serve an important function during a pandemic with regards to an initial assessment and pilot function. This can help relieve not only the emergency services but also the medical facilities responsible for providing further care. The standardised dispatch enquiry enables the linking with the appropriate codes from the low-priority operational spectrum and support by a Tele-emergency physician lends additional professional competency to the emergency paramedics.
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