Ambulante patientenversorgung durch den notarzt: Qualifikationsmerkmal oder nur fehleinsatz?

Background: Patients not requiring hospital admission after assessment by a physician in the emergency medical service are often recorded as "relative false alarms". Our intention was to investigate this practice and to identify a possible correlation with the qualification of the emergency physician. Methods: 1639 missions of the emergency medical-service were investigated and the proportion of cases receiving purely ambulatory care established. A telephone-based inquiry was carried out to determine the post-treatment course of these patients. Results: 222 patients (13.5%) with the diagnoses: trauma 22%, orthostasis 16.7%, convulsion 9.9%, hypoglycemia 9.5%, hyperventilation 8.6%, intoxication 8.6%, asthma / dyspnoea / pneumonia 8.1%, were treated on site, but not hospitalised. Fully qualified physicians treated significantly more patients on site only than physicians-in-training (22% vs. 7.7%). The Mainz-Emergency-Evaluation-Score (MEES) revealed a more effective treatment by the fully qualified physicians. 149 patients were surveyed for the inquiry: 49.7% consulted a GP within 5 days, 2.7% were admitted to hospital within 5 days, 47.6% required no further treatment. Conclusions: Patients treated solely by physicians within the emergency medical services should not automatically be recorded as relative false alarms. Depending on his state of training the emergency physician can make a significant contribution towards relieving the workload of A&E-departments.