We describe the Alternative Pre-Hospital Pathway service, delivered by an EMT and an Emergency Medicine SpR responding to low acuity calls. Increased demand for emergency care and an aging population is necessitating a re-design of traditional models of emergency care delivery. Medical complaints (319), falls (194), drug and alcohol related presentations (193), urological (131), and respiratory complaints (119) were the most common presentations. The average number of patients treated per shift was 7. For patients over 75 years, the non-conveyance rate was 62.0%. The median age was 62 years, with 33.0% of patients aged over 75 years. Two thousand and one patients were attended to with a 67.8% non-conveyance rate. The team are dispatched to low acuity 112/999 calls, aiming to provide definitive care or referring patients to the appropriate community or specialist service.Ī retrospective analysis was performed of the team’s first 12 months of operation using the prospectively maintained service database. The APP Team, consisting of a Specialist Registrar (SpR) in Emergency Medicine (EM) and an Emergency Medical Technician (EMT) based in Cork, covers a mixed urban and rural population of approximately 300,000 people located within a 40-min drive time of Cork University Hospital. The aim of this study is to describe and analyse the APP team service. In this paper the inception of the APP Team is described, and an observational descriptive analysis of the APP Team’s service data presented for the first 12 months of operation. The Alternative Pre-Hospital Pathway (APP) Team is one such Community Emergency Medicine (CEM) initiative developed in Cork, Ireland to target low acuity emergency calls. Internationally increasing demand for emergency care is driving innovation within emergency services.
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