Prehospital COVID-19 Patients Discharged at the Scene – An Observational Study

Background: Emergency medical services (EMS) were the first point of contact for many COVID-19 patients during the pandemic. The aim of this study was to investigate whether the non-conveyance decision of a COVID-19 patient was more frequently associated with a new EMS call than direct ambulance transport to the hospital. Methods: All confirmed COVID-19 patients with an EMS call within 14 days of symptom onset were included in the study. Patients were compared based on their prehospital transport decision (transport vs. non-conveyance). The primary endpoint was a new EMS call within 10 days leading to ambulance transport. Results: A total of 1 286 patients met the study criteria; of these, 605 (47.0%) were male with a mean (standard deviation [SD]) age of 50.5 (SD 19.3) years. The most common dispatch codes were dyspnea in 656 (51.0%) and malaise in 364 (28.3%) calls. High-priority dispatch was used in 220 (17.1%) cases. After prehospital evaluation, 586 (45.6%) patients were discharged at the scene. Oxygen was given to 159 (12.4%) patients, of whom all but one were transported. A new EMS call leading to ambulance transport was observed in 133 (10.3%) cases; of these, 40 (30.1%) were in the group primarily transported and 93 (69.9%) were among the patients who were primarily discharged at the scene (p<.001). There were no significant differences in past medical history, presence of abnormal vital signs, or total NEWS score. Supplemental oxygen was given to 33 (24.8%) patients; 3 (2.3%) patients received other medications. Conclusion: Nearly half of all prehospital COVID-19 patients could be discharged at the scene. Approximately every sixth of these had a new EMS call and ambulance transport within the following 10 days. No significant deterioration was seen among patients primarily discharged at the scene.