[Care of older patients by community emergency paramedics : Comparison of community-dwellers and nursing home residents]. / Versorgung älterer Patienten durch Gemeindenotfallsanitäter : Vergleich der Einsätze im Pflegeheim und in der Häuslichkeit.

ABSTRACT

BACKGROUND: Emergency departments and emergency services are increasingly burdened by non-emergency patients. A substantial proportion of these is represented by older people. The project "community emergency paramedic" ("Gemeindenotfallsanitäter" [G-NFS]) was initiated to prevent unnecessary use of emergency services. OBJECTIVE: To identify specific utilizations of the G­NFS services by older people at home and in nursing homes. MATERIAL AND METHODS: Retrospective analysis of the assignment protocols from July 2019 through June 2020. Only data from patients aged ≥ 65 years were included. Data were grouped into whether patients lived on their own or in nursing homes. RESULTS: A total of 2358 protocols of older patients (mean age 80.8 years; 52.9% female) were evaluated and 55% of patients were treated on-site. The most frequently used measures by G­NFS were counselling (79.4%), aid in self-medication (16.7%) and administration of medication (23.2%). Of the G­NFS assignments 329 (14.0%) were carried out for nursing home residents. Measures related to urine catheter complications were more frequently performed in nursing home residents than in patients who lived at home (32.2% vs. 5.7%). Compared to other emergency cases, patients with catheter-related complications were most often treated at the scene (84.3% vs. 52.2%). CONCLUSION: The G­NFS enabled the majority of patients to be treated on-site, thus saving resources of emergency services and hospitals; however, the G­NFS also performed measures that were normally the responsibility of general practitioners. This possibly highlights structural deficits in the medical and nursing care of older people.