112 health services retrospective analysis of ambulance transport case

Introduction and Objective: This study was carried out to investigate the reasons for the admission of patients who were brought to Tokat Gaziosmanpaşa University Training and Research Hospital between 25/02/2022-15/08/2022 with 112 and referred to a hospital other than TOGU. In this study, the patients with which diagnosis were transported, what was done in the ambulance, the consistency of the preliminary diagnosis and the hospital diagnosis, the waiting times in the hospital and the reasons for the referral were taken into consideration. This study was planned to determine the misuse of 112 KKM ambulances and to shed light on the deficiencies. Materials and Methods: This study, which was designed retrospectively, was carried out with data records obtained from Tokat Gaziosmanpaşa University Hospital Emergency Service yellow area (ENLİL HBYS system and patient files) and 112 Command and Control Center (KKM) records. Statistical analyzes were made in IBM SPSS Statistics Version 22 package program. Mean ± standard deviation, percentile distributions, dependent sample t-test, and chi-square test were used in the evaluation of the data. p<0.05 was considered statistically significant. Results: Of the 652 patients included in the evaluation, 50% were male and 50% were female, and 33% were aged 65 and over. Considering the application hours of the cases, the highest number of applications was between 8-16 hours with 47.2%. It was determined that the KKM reported the cases to the ambulance teams within 1-2 minutes on average, the ambulance teams left the station in 61-90 seconds (40.3%) on average, and the ambulance personnel reached the cases within an average of 0-10 minutes (57.2%). It was determined that most of the cases (35.4%) were taken from the house. Considering the preliminary diagnoses made in 112 KKM ambulances; it was observed that the most common were 22.3% neurological patients, 22.1% trauma patients, 17.3% cardiac patients. Looking at the hospital diagnoses; it was observed that the most 20.9% trauma patients, 20.1% cardiac patients, 18.7% neurological patients. Considering the length of stay of the patients in the ED in the primary health care institution; The number of patients staying 0-1 hours was 2 (4.5%), the number of patients staying 1-2 hours was 11 (25%), the number of patients staying 2-3 hours was 12 (27.3%), and the number of patients staying longer than 3 hours was 29 (65.9%). Considering the duration of stay in the emergency room of the patients in the cases that occurred in the second level health institution; It was observed that the number of patients staying for 1-2 hours was 9 (4.2%), the number of patients staying for 2-3 hours was 9 (4.2%), and the number of patients staying in the emergency room for more than 3 hours was 198 (91.7%). It was observed that patients were referred from the TOGU emergency department most frequently due to the need for intensive care. It was observed that 48.2% of the patients stayed in the emergency department for at least 3 hours and 48.5% were discharged from the outpatient clinic. Conclusion: According to the results of the study, it was determined that the elderly population benefited more from ambulance services in proportion to the increase. For this reason, it was determined that 112 ambulance crews served more medical patients than traumas. It was observed that most of the cases brought to the 3rd step emergency department were patients who could easily apply as an outpatient and did not require ambulance service. For this reason, it is thought that authorizing ambulance personnel to determine the appropriateness of intervention and transport at the scene with a teleconference doctor connection or increasing the number of ambulances with doctors will reduce the workload of 112 and hospital personnel.