Effects of the COVID-19 pandemic on trauma-related emergency medical service calls: a retrospective cohort study

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Abstract

Background

The COVID-19 pandemic has had profound effects on the utilization of health care services, including Emergency Medical Services (EMS). Social distancing measures taken to prevent the spread of the disease have greatly affected the functioning of societies and reduced or halted many activities with a risk of injury. The aim of this study was to report the effects of lockdown measures on trauma-related EMS calls in the Finnish capital area.

Methods

We conducted a retrospective cohort study of all EMS calls in the Helsinki University Hospital (HUH) catchment area between 1 January and 31 July 2020. Calls were identified from the HUH EMS database. Calls were grouped into pre-lockdown, lockdown, and post-lockdown periods according to the restrictions set by the Finnish government and compared to the mean number of calls for the corresponding periods in 2018 and 2019. Statistical comparisons were performed using Mann-Whitney U-test for weekly numbers and percentages.

Results

During the study period there was a total of 70,705 EMS calls, of which 14,998 (21.2%) were related to trauma; 67,973 patients (median age 61.6 years; IQR 35.3–78.6) were met by EMS. There was no significant change in the weekly number of total or trauma-related EMS calls during the pre-lockdown period. During the lockdown period, the number of weekly total EMS calls was reduced by 12.2% ( p = 0.001) and the number of trauma-related calls was reduced by 23.3% ( p = 0.004). The weekly number of injured patients met by EMS while intoxicated with alcohol was reduced by 41.8% ( p = 0.002). During the post-lockdown period, the number of total and trauma-related calls and the number of injured patients intoxicated by alcohol returned to previous years’ levels.

Conclusions

The COVID-19 pandemic and social distancing measures reduced the number of trauma-related EMS calls. Lockdown measures had an especially significant effect on the number of injured patients intoxicated by alcohol met by the EMS.

Trial registration

Not applicable.

Related collections

Most cited references 10

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The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

Erik von Elm, Douglas G. Altman, Matthias Egger … (2008)

Much of biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.

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NON-COVID-19 VISITS TO EMERGENCY DEPARTMENTS DURING THE PANDEMIC: THE IMPACT OF FEAR

Guglielmo Mantica, Niccolò Riccardi, Carlo Terrone … (2020)

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Effect of the Coronavirus Disease 2019 (COVID‐19) Pandemic on the United States Emergency Medical Services System: A Preliminary Report

E Brooke Lerner, Craig Newgard, N Mann (2020)

Abstract Background Our objective was to quantify trends in Emergency Medical Services (EMS) incidents as the effects of the COVID‐19 pandemic spread across the United States, and to determine if there was an increase in EMS attended deaths. Methods We conducted a three‐year comparative retrospective cohort analysis of data from the National EMS Information System. Data were included if care was provided between the 40th and 21st week of the next year and compared over three‐years. We included incidents identified through 9‐1‐1 where patient contact was made. The total number of EMS incidents per week was used as the denominator to calculate the rate of patient deaths and possible injury. We assessed for temporal and seasonal trends. Results Starting in the 10th week of 2020 there was a decrease in the number of EMS activations in the United States compared to the prior weeks and the same time period in previous years. The number of activations between week 10 and 16 decreased by 140,292 or 26.1%. The portion of EMS activations reporting a patient disposition of death nearly doubled between the 11th and 15th week of 2020 (1.49% to 2.77% of all activations). The number of EMS activations documenting a possible injury decreased from 18.43% to 15.27% between weeks 10 and 13. Conclusion We found that early in the COVID‐19 outbreak there was a significant decrease in the number of EMS responses across the United States. Simultaneously the rate of EMS attended death doubled, while the rate of injuries decreased.

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Author and article information

Contributors

Michael Azbel: michael.azbel@lshp.fi

Journal

Journal ID (nlm-ta): BMC Emerg Med

Journal ID (iso-abbrev): BMC Emerg Med

Title: BMC Emergency Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-227X

Publication date (Electronic): 9 September 2021

Publication date PMC-release: 9 September 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 102

Affiliations

[1 ]GRID grid.415813.a, ISNI 0000 0004 0624 9499, Prehospital Emergency Care Services, , Lapland Central Hospital, ; P.O. Box 8041, FI-96101 Rovaniemi, Finland

[2 ]GRID grid.15485.3d, ISNI 0000 0000 9950 5666, Department of Emergency Medicine and Services, , Helsinki University and Helsinki University Hospital, ; P.O. Box 340, FI-00029 HUS Helsinki, Finland

[3 ]GRID grid.15485.3d, ISNI 0000 0000 9950 5666, Trauma Unit and Helsinki Trauma Registry, , Helsinki University Hospital, ; P.O. Box 266, FI-00029 HUS Helsinki, Finland

[4 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Department of Orthopaedics and Traumatology, , University of Helsinki and Helsinki University Hospital, ; Helsinki, Finland

Article

Publisher ID: 495

DOI: 10.1186/s12873-021-00495-3

PMC ID: 8426589

PubMed ID: 34503453

SO-VID: 616b2352-5ad4-49de-8efd-70e1a60c1d1e

License:

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