title: Trends of pre-hospital emergency medical services activity over 10 years: a population-based registry analysis.
abstract: BACKGROUND
  The number of requests to pre-hospital emergency medical services (PEMS) has increased in Europe over the last 20 years, but epidemiology of PEMS interventions has little be investigated. The aim of this analysis was to describe time trends of PEMS activity in a region of western Switzerland.
  
  
  METHODS
  Use of data routinely and prospectively collected for PEMS intervention in the Canton of Vaud, Switzerland, from 2001 to 2010. This Swiss Canton comprises approximately 10% of the whole Swiss population.
  
  
  RESULTS
  We observed a 40% increase in the number of requests to PEMS between 2001 and 2010. The overall rate of requests was 35/1000 inhabitants for ambulance services and 10/1000 for medical interventions (SMUR), with the highest rate among people aged ≥ 80. Most frequent reasons for the intervention were related to medical problems, predominantly unconsciousness, chest pain respiratory distress, or cardiac arrest, whereas severe trauma interventions decreased over time. Overall, 89% were alive after 48 h. The survival rate after 48 h increased regularly for cardiac arrest or myocardial infarction.
  
  
  CONCLUSIONS
  Routine prospective data collection of prehospital emergency interventions and monitoring of activity was feasible over time. The results we found add to the understanding of determinants of PEMS use and need to be considered to plan use of emergency health services in the near future. More comprehensive analysis of the quality of services and patient safety supported by indicators are also required, which might help to develop prehospital emergency services and new processes of care.
authors.affiliation: Institute of social & preventive medicine (IUMSP), Lausanne University Hospital, Route de la Corniche 10, CH-1010 Lausanne, Switzerland. Valerie.Pittet@chuv.ch.
authors.forename: Valérie
authors.initials: V
authors.lastname: Pittet
authors.forename: Bernard
authors.initials: B
authors.lastname: Burnand
authors.forename: Bertrand
authors.initials: B
authors.lastname: Yersin
authors.forename: Pierre-Nicolas
authors.initials: PN
authors.lastname: Carron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D016019:Survival Analysis; D013557:Switzerland; D055815:Young Adult