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. 2009 Oct;55(10):1004-5.e1-4.

Frequency of in-office emergencies in primary care

Clare Liddy  1 , Heather Dreise, Isabelle Gaboury
Affiliations

Frequency of in-office emergencies in primary care

Clare Liddy et al. Can Fam Physician. 2009 Oct.

Abstract
in English, French

Objective: To quantify the frequency and types of in-office emergencies seen by FPs.

Design: A retrospective descriptive analysis of the frequency and types of in-office emergencies seen by FPs was done using the City of Ottawa Emergency Medical Services database.

Setting: Community medical offices in the Ottawa, Ont, region during a 3-year period (2004 to 2006).

Participants: All patients for whom an ambulance was called to a medical office or clinic during the study period.

Main outcome measures: Number of emergency calls from FPs' offices, primary complaints, seasonal variation, distance to the nearest emergency facility, and patients' demographic characteristics.

Results: A total of 3033 code 04 (life-threatening) emergency calls were received from FPs' offices during the study period. Demographic analysis of the calls showed that 91.3% of calls were regarding adult patients with an average age of 51.5 years. There was an overall statistically significant difference in the sex of the patients presenting (P < .001), but it was attributable to calls about genitourinary emergencies, which were almost all for women. The most common type of emergency reported was cardiovascular complaints. Of the 992 cardiovascular emergencies, 74.3% were complaints of ischemic chest pain.

Conclusion: There is a great burden on the health care system from emergency calls, with continued unpreparedness from FPs. Clearly, FPs must take seriously the risk of being unprepared for in-office emergencies. Dissemination strategies must be developed so that the guidelines that have been developed can be effectively implemented in FP offices across the country.

OBJECTIF: Déterminer la fréquence et le type d’urgences que les MF rencontrent au bureau.

TYPE D’ÉTUDE: Une analyse descriptive rétrospective de la fréquence et du type d’urgences que les MF voient au bureau a été effectuée à l’aide de la base de données des services médicaux d’urgence de la ville d’Ottawa.

CONTEXTE: Bureaux médicaux communautaires de la région d’Ottawa, Ontario, durant une période de 3 ans (2004 à 2006).

PARTICIPANTS: Tout patient pour lequel on a demandé une ambulance à un bureau de médecin ou une clinique médicale durant la période d’observation.

PRINCIPAUX PARAMÈTRES À L’ÉTUDE: Nombre d’appels d’urgence venant de bureaux de MF, plaintes initiales, variations saisonnières, distance du service d’urgence le plus proche et caractéristiques démographiques des patients.

RÉSULTATS: Au total, 3033 appels d’urgence (code 04, danger de mort) ont été reçus de bureaux de MF durant la période d’observation. L’analyse démographique des appels révèle que 91,3 % des appels concernaient des patients adultes ayant en moyenne 51,5 ans. Dans l’ensemble, on notait une différence statistiquement significative dans le sexe des patients concernés (P < .001), laquelle était toutefois due à des appels pour des urgences génito-urinaires qui provenaient presque toutes de patientes. Le type d’urgence le plus souvent rapporté concernait des problèmes cardiovasculaires. Sur 992 urgences cardiovasculaires, 74,3 % concernaient des douleurs thoraciques ischémiques.

CONCLUSION: Les appels d’urgence représentent un fardeau important pour le système de santé, alors que la préparation des MF demeure déficiente. De toute évidence, les MF doivent prendre au sérieux le risque d’être mal préparés en cas d’urgence au bureau. On doit mettre au point des stratégies d’information pour que les directives existantes soient instaurées de façon efficace dans les bureaux des MF partout au pays.

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References

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