Evaluation of the misuse of pre-hospital ambulance services and triage performance: A single-center study

Abstract

Background: Inappropriate use of emergency health services and increasing admission to emergency services (ES) are universal problems. Objectives: This study aimed to evaluate the appropriateness of using prehospital emergency health services and triage performance in the ES.Methods: Patients over 18 who were transported to the emergency service were included in the study. Data were obtained by screening Turkish Prehospital Ambulance Services (112 Emergency Medical Services) case forms, hospital information recording systems, and patient files. The emergency status of the patients, medical records, International Classification of Diseases-10 (ICD-10) diagnosis codes, triage categories, vital signs, and the necessity for hospitalization were evaluated according to the International List of 32 Emergency Parameters.Results: The study included 1029 cases. The median age of the patients was 51.0 years, and 51.0% were male. 112 Emergency Health Services transported 27.7% of the cases to our hospital with the diagnosis of trauma and 72.3% with the diagnosis of non-trauma emergency. Triple system triage was applied to 69.9% of the transported cases; 4.8% were given red, and 43.0% were given green triage codes. The proportion of applicants who met the 32 international emergency parameters determined by the World Health Organization was 35.4%, while 64.6% were not accepted as emergencies according to the same parameters. Moreover, 77.7% of patients admitted with a preliminary diagnosis of trauma and 76.6% of patients admitted with non-trauma diagnoses were discharged.Conclusion: When the need for hospitalization, ES diagnoses, and triage codes were evaluated, it was concluded that most transported cases did not have an emergency medical condition, and prehospital emergency health services were misused. Emergency health service providers should use appropriate triage scales to reduce the density and prevent unnecessary use.

Keywords

• ambulances
• triage
• emergency service