caa a22 4500 555311120 20200410031630.0 cr unu---uuuuu 190207s2018 xx s 000 0 eng 1932-6203 10.1371/journal.pone.0191879 doi (BORIS)oai:boris.unibe.ch:124987 610 ddc 29485991 pmid The dead and the dying - a difficult part of EMS transport: A Swiss cross-sectional study [Elektronische Daten] [Rebecca Maria Hasler, Sandra Stucky, Heinz Bähler, Aristomenis Exadaktylos, Frank Neff] publishedVersion openAccess eu-repo Objective Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel. As there is little epidemiological data about these patients, this paper aims to describe this special population. Methods Retrospective cross-sectional study on adult patients transported by ground ambulance to the ED of a Swiss university hospital, who died during their stay in the ED between January 2008 and December 2012. Data was collected on the basis of ambulance report forms and discharge summaries of the ED. Results One hundred and sixty-one patients were analysed. Most deaths were due to cardiovascular diseases (43%). Only 9% of patients died of trauma. The median age was 70 years (IQR 56-81 years) and 70% (n = 112) were men. Trauma patients were significantly younger (median age 55 years, p<0.001). The overall mortality rate was 0.9% for all patients transported by EMS to the ED. About one third of all patients received cardiopulmonary resuscitation (CPR) from bystanders (n = 53). The most common electrocardiogram (ECG) findings were asystole (n = 57) and pulseless electrical activity (n = 91). Fifty percent (n = 64) of the resuscitated patients were defibrillated. Three quarters (n = 115, 72%) of all patients were intubated on site. The mechanical chest compression device Lucas™2 was mainly used in cases of cardiovascular or uncertain cause of death and did not reduce the operating time on site. Conclusion The low ED mortality rate of 0.9% shows that only a few dying patients are transported to hospital. However, transport to hospital has to be carefully evaluated, especially for elderly patients with asystole or PEA due to medical conditions. The low CPR rate from bystanders demonstrates that public CPR training should be promoted further. The use of Lucas™2 did not reduce the operating time on site. For further investigations, comparison with survivors would be needed. Hasler Rebecca Maria joint author Stucky Sandra joint author Bähler Heinz joint author Exadaktylos Aristomenis joint author Neff Frank joint author PLoS ONE 13(2), e0191879 1932-6203 https://boris.unibe.ch/124987/1/journal.pone.0191879.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/124987/1/journal.pone.0191879.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Hasler Rebecca Maria joint author BORIS 700 1- Stucky Sandra joint author BORIS 700 1- Bähler Heinz joint author BORIS 700 1- Exadaktylos Aristomenis joint author BORIS 700 1- Neff Frank joint author BORIS 773 0- PLoS ONE 13(2), e0191879 1932-6203 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess