A report on emergency service by ambulance with doctor on board of the Emergency Department of Prato, Italy

In the urban area of Prato (population 172,473 01.01.2000), the Emergency Department runs three ambulances with doctor on board coordinated by the emergency number 118. Here we analysed the typology of 798 consecutive services carried out by our ambulance from 01.08.1998 to 31.01.1999. Twenty-eight services (3.5%), canceled for various reasons, were excluded by the statistical analysis. 770 patients were visited; 402 (52.2%) were males and 368 females (47.8%); males were significantly younger than females (53.8 ± 24.2 vs 59.9 ± 17 years, P = 0.001). 75.5% of services concerned non-traumatic cases, 17.9% traumatic cases and 6.6% transfers between hospitals. The services for non-trauma group, concerned dyspnoic symptoms (15.7%), cases of lipothimia (15.2%), chest pain (11.1%), mental disorders (7.9%), cerebrovascular pathology (6.8%), abdominal pain (4.4%), use of psychotropic substances (4.3%), epileptic and not epileptic convulsions (3.5%). Metabolic disorders (diabetes, hypoglycemic crises, hyperthyroidism) accounted for 2.4% of cases, hypertensive crises 2.4%, tachycardia 2.2%, support to patients with terminal cancer 2.2%, vertigo 2%, allergies 1.1% and obstetric pathology 0.9%. 1.9% of cases required cardiopulmonary resuscitation. 15.9% was a miscellany of services including poisonings, migraines, haemorrhages, flu syndromes. Trauma cases were road accidents (64.7%), falls (27.2%), work-related accidents (4.4%) and aggression (3.7%). 75.8% of patients were admitted to hospital; the others (24.2%) were not urgent or refused hospitalisation. According to Sonsin et al [1], the most frequent services were related with cardiorespiratory pathologies, cases of lipothimia and trauma so as the % of non-hospitalised patients (24.2% vs 23%). The % of our traumatic cases is like that found by Brismar et al [2] in Sweden urban areas (17.9% vs 20%). Cases of cardiopulmonary resuscitation were 1.9%, similar to 1.8% found by Hu et al [3]. Further studies are in progress.