Characteristics of emergency medical service (EMS) calls to mentally disabled residents of a social welfare home.

Abstract

INTRODUCTION: The problem of disability in the modern world affects a significant number of people of different ages. Mental disability is a disorder characterised by limitations in a person's intellectual functioning, social, and adaptive behavior, appearing before the age of 18. According to a report published in 2022, there were 897 social welfare homes in Poland, of which there were up to 16,412 residents with disabilities. Interventions in emergency medical services for mentally disabled patients require an interdisciplinary approach. The purpose of the study is to attempt to outline the profile of a patient with mental disabilities from the perspective of the emergency medical services (EMS) team, as well as to indicate the characteristics of calls to social welfare homes. MATERIAL AND METHODS: A retrospective analysis included 125 patients who were treated by emergency services at the "Pomocna Dłoń" Social Welfare Home (SWH) in Wirów (central Poland). Data on the time of call, urgency code, type of team dispatched, and reason for call were analysed. The following data were extracted from all information about patients: age, gender, medical rescue procedures performed, supply of sedatives to patients, diagnosis, and destination of patient transport. In the statistical analysis, the significance threshold was established at p<0.05. RESULTS: During the period under study, the emergency services performed a total of 125 interventions. The highest number of interventions took place in the afternoon and evening (49.6%). 59.2% of the trips were made to men (n=74) and 40.8% to women (n=51). The mean age of the patients was 62.6 (SD ± 17.91) years. The most common reason for calling EMS was shortness of breath (n=16; 12.8%), while the most common diagnosis was cystostomy dysfunction (n=15; 12%). The final destination of transport for most patients was the hospital outpatient department (52.8%), the second place was the emergency department - ED (23.2%), and the third place was the psychiatric department (11.2%). 12.8% of the patients were helped at the scene, without having to be transported to hospital. CONCLUSIONS: A mentally disabled patient in a nursing home to whom EMS is called is usually a middle-aged man. The number of interventions increases in the evenings. The most common reason for emergency medical services calls is shortness of breath, which is not confirmed by on-scene examination. Every tenth patient did not require transport to the hospital, raising doubts as to the validity of calling an emergency medical team. Human resources and organizational solutions should be considered to improve the quality of medical care and the supply of emergency medicines in social welfare homes, without the need for emergency services.

Keywords

• mental disability
• emergency medical service
• medical interventions
• nursing home.