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Background: Our population is aging. There is a growing number of nursing home (NH) residents who benefit from ambulance
transport to the emergency department (ED) , which are not known to be �seniors friendly� and are often on surge capacity.
Simultaneously, we face a reduced availability of general practitioners (GP) to visit these patients prior their transport to the ED.
Hypothesis: Many NH patients are transported by ambulance to the ED without having benefitted from a medical evaluation on site.
Palliative and end of life care could sometimes be provided on site rather than having the patient transported.
Setting: The State of Vaud (Switzerland) dispatch centre sends ambulances and, when a life-threatening situation is suspected, a
prehospital emergency physician (PEP).
Results: We previously published a case series where PEPs have been able to provide palliative and end of life care on site, according
to the patient and relative�s will, and we with the support of the NH.
Discussion: EMS systems that dispose of PEPs should use this resource not only for life-threatening emergencies but also to provide
palliative and end of life care, when all parties (patient, relatives, NH) agree with this strategy, therefore avoiding unnecessary
transport to crowded ED.
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