[Development of events in medical emergency situations in a rural community].

BACKGROUND: A comprehensive study of medical emergency situations in a rural community in Norway has been undertaken for the first time. Some results from this study are presented; i.e. data on events (types and management) that occur in medical emergency situations.

MATERIAL AND METHODS: Austevoll is an island community in western Norway, with about 4400 inhabitants. Data on all events in medical emergency situations were recorded during two years. The following information was recorded: degree of urgency at the time of the emergency call and at patient examination (as assessed by the doctor), treatment measures and the relationship between doctors' and ambulance personnel's assessments.

RESULTS: 236 medical emergency events were recorded. The doctors downgraded the seriousness of the event (from emergency call to actual examination of the patient) in 43 % of cases, while the event was upgraded in 11 %. For alarms dispatched from the emergency medical communication centres, the doctors downgraded the evaluation of seriousness in the time span alarm-examination in 67 % of cases, while the ambulance personnel downgraded seriousness in 85 %. Home dwelling was the initial location of treatment in 63 % of patients. The procedures performed most frequently were: venous cannulation, airway handling (including administration of oxygen), ECG-recording and/or monitoring of cardiac rhythm, and parenteral administration of drugs.

INTERPRETATION: For emergency medicine work general practitioners should focus on training fundamental practical skills. The doctors and the ambulance personnel have complementary roles in handling of medical emergency events. Ability of obtaining an adequate overall view of the patient's condition is an important aspect of the doctor's role.