Evaluation of emergency medical responses to nursing homes in a local area of Germany
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Springer Nature
Abstract
Background: In rural areas with low population density, emergency medical services (EMS) are often the first
source of acute medical care in nursing homes (NHs) when nursing staff are unable to manage the situation, and
no specialist practitioner is immediately available. This study analysed EMS responses to NHs in a German region to
evaluate their frequency, causes, and outcomes.
Methods: This cross-sectional study analysed EMS responses to NHs in a German region from July 2020 to December
2024. Prehospital patient care was assessed using the ABCDE approach, with additional analysis of feedback codes
transmitted to the control centre. Data were presented through descriptive statistics.
Results: Among 81,727 EMS responses, 55,900 were acute emergencies, including 5,738 cases to NHs. The
median age of NH patients was 84 years (IQR 78–89), with 41% male and 59% female. Spontaneous breathing
was unremarkable in 72% (4,141/5,738) of cases. A pulse rate of 60–100 beats per minute was recorded in 71%
(4,093/5,738), and systolic blood pressure ranged between 100 and 140 mmHg in 45% (2,572/5,738). Neurologically,
80% (4,570/5,738) were classified as ‘alert’, and 12% (674/5,738) as ‘responsive to speech’. The most common diagnoses
included fractures (face, head, extremities) and pneumonia. In 81.6% of cases, disturbances in all vital signs were
classified as ‘low’ to ‘moderate’.
Conclusion: Most EMS responses to NHs involved patients with stable vital signs, and critically acute conditions
were rare. Hospital admissions were predominantly ‘non-urgent’, with patients mainly transferred to primary care
hospitals, which typically offer basic medical services, suggesting lower medical complexity. Falls and related injuries,
particularly suspected hip fractures, were the leading reason for EMS utilisation. These findings highlight the need for
targeted strategies to enhance the management of ‘non-urgent’ cases within NHs and to reduce avoidable hospital
admissions, which may partly result from limited access to medical support.
Trial registration: This study was registered in the German Clinical Trials Register on 17 December 2024 (ID
DRKS00035675).
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