key: cord-0805765-ym1oue1j
authors: Penverne, Yann; Jenvrin, Joel; Montassier, Emmanuel
title: EMS dispatch center activity during the COVID-19 containment
date: 2020-08-05
journal: Am J Emerg Med
DOI: 10.1016/j.ajem.2020.07.083
sha: 54131555c42b44311fed86245b4b48be6deaf7f1
doc_id: 805765
cord_uid: ym1oue1j

nan

To the Editor:

Since reported in late December 2019 from the Hubei province in China, coronavirus disease 2019 (COVID-19) has spread worldwide with more than 6 million confirmed cases by the end of May 2020 1 . In Europe, emergency departments (ED) noticed a decrease of daily visits since the beginning of the outbreak, which majored during the implementation of containment measures 2 . However, to date, no data reported Emergency Medical Services (EMS) dispatch center activity during COVID-19 containment.

This retrospective study was conducted at the EMS dispatch center of Nantes University Hospital, France, from March 17 th to May 11 th 2020, corresponding to the lockdown period in France. We also collected data from the two same time periods of 2018 and 2019. Data were extracted from the advanced telephone that automatically keeps track of all incoming calls. Quantitative variables reported using median were compared using Kruskal-Wallis test, p-values were adjusted with the Bonferroni method. Qualitative data reported using percentage were compared using Chisquare test, p-values were adjusted with the false discovery rate method.

During the containment period, we received 69845 calls (1216 calls/day, 1021-1391). Compared to 2019 and 2018, the number of calls increased during the first thirteen days of the containment (+31% and 33%, p<0.001 for both), but followed by a significant decrease (-11% and -13%, p=0.01 and p<0.001, Figure 1 ). Compared to 2019, we observed a significant increase in calls related to infection (n=6448 (12%), +164%, p<0.001), chest pain (n=1961 (4%), +43%, p<0.001), and breathing difficulties (n=3686 (7%), +121%, p<0.001). Conversely, we observed a significant decrease in calls related to severe trauma (n=64 (0.1%), -50%, p<0.001), minor injuries (n=4864 (9%), -22%, p<0.001), altered level of consciousness (n=283 (1%), -17%, p<0.001), patients with intoxication (n=475 (1%), -7%, p=0.05), seizure (n=2197 (4%), -39%, p<0.001), and abdominal pain/diarrhea/vomiting (n=2703 (5%), -11%, p<0.001). However, compared to 2019 and 2018, we did not find significant change in calls related to cerebrovascular accident (n=333 (6.2%), +6.7% and +12%, p=0.9 for both). Moreover, out-of-hospital cardiac arrest (OHCA, n=258 (0.5%) J o u r n a l P r e -p r o o f care unit with an emergency physician on board (n=530 (1%), -25%, p<0.001).

Moreover, more patients were left on scene (n=25319 (64%), + 34%, p<0.001) and less were transported to the hospital (n=13344 (34%), -21%, p<0.001). Among them, more patients were transferred to the intensive care unit (n=627 (6%), +7.5%, p<0.001) and less were admitted to the ED (n=9499 (85%), -21%, p<0.001).

However, we did not observe a significant change in the number of patients with STEMI transferred for urgent PCI (n=66 (0.6%), -12%, p=0.9).

Here, we found that our EMS dispatch center received more calls related to infection, chest pain and breathing difficulties during the containment period. EMS physicians addressed less patients to the ED, which may have contributed to the decrease of daily ED visits 2 and saved hospitals' resources. 

The study protocol was approved by the ethics committee of the Nantes University Hospital.

Please contact author for data requests.

No funding received for this work.

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