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Background <p>The numbers of deployments for emergency medical services (EMS) and patient presentations to the emergency department has steadily increased in recent years. A&#xa0;decision against transport to the emergency department is often difficult to make in the prehospital environment due to limited diagnostic options. The aim of this study was to determine how often the assessment of EMS personnel is correct compared with the assessment of the emergency physician of the emergency department.</p> Methods <p>We conducted a&#xa0;prospective trial in two major emergency departments and asked EMS personnel if the patient needs to be seen in an emergency department based on their assessment. The responses were compared with the emergency physician’s assessment upon presentation, as well as with the final decision regarding hospital admission.</p> Results <p>In total, we recorded 1063 cases between March and August 2024. In 19.2% (200/1041; 95% confidence interval 16.9–21.7%) of cases, EMS deemed that presentation to the emergency department was not indicated. Compared to the assessment of the emergency department physician, the rate of incorrect assessments was calculated as 48.5% (97/200). In 55.7% (54/97) of cases this led to hospital admission and admission to intensive care in 9.3% (9/97) of the patients.</p> Conclusion <p>The need for presentation to the emergency department was not correctly assessed in 50% of the patients identified as suitable for outpatient care. There are no validated decision rules or clinical guidelines for paramedics that allow a&#xa0;redistribution of emergency patients to general practice and the assessment of the need for emergency department presentation is not part of their training.</p>

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Transportverzicht durch Rettungsdienstpersonal

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月27日

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  • Matthias Bollinger,
  • C. Huhn,
  • J. Holst,
  • C. Villain,
  • K. Görendt,
  • B. Kumle,
  • M. Kohl,
  • C. Kill,
  • J. Risse

摘要

Background

The numbers of deployments for emergency medical services (EMS) and patient presentations to the emergency department has steadily increased in recent years. A decision against transport to the emergency department is often difficult to make in the prehospital environment due to limited diagnostic options. The aim of this study was to determine how often the assessment of EMS personnel is correct compared with the assessment of the emergency physician of the emergency department.

Methods

We conducted a prospective trial in two major emergency departments and asked EMS personnel if the patient needs to be seen in an emergency department based on their assessment. The responses were compared with the emergency physician’s assessment upon presentation, as well as with the final decision regarding hospital admission.

Results

In total, we recorded 1063 cases between March and August 2024. In 19.2% (200/1041; 95% confidence interval 16.9–21.7%) of cases, EMS deemed that presentation to the emergency department was not indicated. Compared to the assessment of the emergency department physician, the rate of incorrect assessments was calculated as 48.5% (97/200). In 55.7% (54/97) of cases this led to hospital admission and admission to intensive care in 9.3% (9/97) of the patients.

Conclusion

The need for presentation to the emergency department was not correctly assessed in 50% of the patients identified as suitable for outpatient care. There are no validated decision rules or clinical guidelines for paramedics that allow a redistribution of emergency patients to general practice and the assessment of the need for emergency department presentation is not part of their training.