The role of emergency medical services in the management of in-hospital emergencies: Causes and outcomes of emergency calls - A descriptive retrospective register-based study.

BACKGROUND: Medical emergency teams (METs) are in place in some hospitals in Finland to respond to critical emergency events. However, in hospitals without dedicated METs, staff are instructed to call emergency medical services (EMS) to deal with emergencies. This study examined the reasons for calling EMS to hospitals and the outcomes of these calls. METHODS: Descriptive retrospective register-based study of the response and management of in-hospital emergencies by EMS in the wellbeing services county of Southwest Finland. Patient care reports of the EMS and those of the hospitals were analysed. RESULTS: In total, 138 medical emergencies managed by EMS were included in this study. 108 of these related to patients, and 25 related to hospital personnel. Cardiac arrest (n = 36) and a reduced level of consciousness (n = 29) were the most common in-hospital emergencies. In 68% of in-hospital emergencies managed by the EMS team, after calling 112, hospital personnel implemented various treatment measures. In 72% of cases, follow-up treatment was required. CONCLUSIONS: Hospital personnel are able to initiate medical measures in emergencies, even when no MET is available. Although EMS are important in responding to in-hospital emergencies, they seem to be performing the same role as METs.

Maintenance and Development of Paramedics' Competence on Joint Emergency Medical Service and Helicopter Emergency Medical Service Missions.

OBJECTIVE: In health care, learning and collaboration between professions are crucial in providing patient-centered, responsive, and high-quality care. Given that interprofessional learning can occur indirectly while working but is scarcely studied in the context of prehospital emergency care, we examined the maintenance and development of paramedic competence on joint emergency medical service (EMS) and helicopter emergency medical service (HEMS) missions. METHODS: Qualitative methodology was chosen. Sixty-one Finnish paramedics and EMS field supervisors answered a single open-ended survey question. Inductive content analysis was used to analyze the data. RESULTS: The maintenance and development of paramedics' competence on joint EMS and HEMS missions formed 2 main categories: the transfer of professional skills and interactive competence development. The transfer of skills was formed by 3 upper categories: practicing working as part of the team, transmission of tacit knowledge, and deepening of clinical knowledge. Interactive competence development was formed by 2 upper categories: ensuring one's own competence and educational working model as built-in. All the upper categories had several subcategories. CONCLUSION: EMS and HEMS joint missions provide an additional learning opportunity for paramedics. The expertise, examples, and educational attitudes shared by the HEMS are valued. The results reveal the need for further research on this subject.