St John medics see increase in chest pain, breathing problems, strokes, eye issues

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St John Ambulance has continued to be there for New Zealanders throughout the COVID-19 pandemic in 2021, responding to more than half a million emergencies across the year.

Similar to 2020, the reduced movement of New Zealanders – particularly in Auckland due to extended lockdowns – resulted in fewer trauma related incidents, however overall, 111 call volumes in 2021 increased nationwide to 606,503 – 9.6 percent more than in 2020 (553,286).

Dan Ohs, St John Deputy Chief Executive – Ambulance Operations, says 2021 was another extremely busy year with the COVID-19 pandemic continuing to create ongoing challenges across the emergency ambulance service.

“This prolonged significant demand is compounded by a challenging work environment due to COVID-19 and longer times for ambulance crews to complete 111 call-outs due to additional safety precautions that must be taken both at the scene, during transport and at hospital.

“Our emergency call handlers responded to a significant number of calls in July and December last year – both recording more than 55,000 calls for each month. In December alone we recorded 56,692 calls – a 9.8 percent increase on December 2020,” says Mr Ohs.

Trauma related ambulance call-outs fell 12.3 percent in the period from July – December in 2021 (6,553 incidents) when compared with the same period in 2020 (7,474 incidents).

In contrast, there was a concerning rise in the number of mental health and suicide attempt incidents – which were up 30 percent on the previous year.

Children

“We continue to respond to very distressed and vulnerable patients but the most disturbing trend out of these types of incidents, is the number involving patients aged under 14.

“This age group had a 36 percent increase in 2021 (up 49 patients to 186 patients) compared to the previous year (137 patients) and was 77 percent higher compared to 2019 (105 patients).”

Chest Pain

St John also saw a notable increase in patients with chest pain and breathing problems – an increase of 15.5 percent and 14.4 percent respectively – which along with the rise in mental health related call-outs, St John attributes to the direct impact of COVID-19 or COVID-19 lockdowns.

2021 saw the completion of St John’s four-year project to double crew all transporting ambulances, of which 99.8 percent of transporting ambulances are now fully crewed. This has significantly benefited rural New Zealand which now has the same crewing levels as urban areas. The initiative has not only made it safer for ambulance officers but has enabled patients to be cared for while enroute to hospital.

St John has continued to work on reducing pressure on hospital emergency departments, with its specialised extended care paramedic role, which has provided more than 7,700 patients with treatment in their home and referrals to more appropriate health care, leading to fewer unnecessary hospital presentations.

Endemic

St John Ambulance is preparing for another challenging year ahead in 2022 as New Zealand moves from a pandemic response to COVID-19 to endemic.

“We’ve seen the impact of the Omicron variant in other parts of the world and it’s just a matter of time before we experience a widespread outbreak here in Aotearoa. St John is well adept at responding to patients with infectious conditions and we have several contingency plans underway to lessen the impact it might have on our capability, including bolstering our recruitment and training efforts to bring on board more ambulance officers,” says Mr Ohs.

Breakdown of emergency ambulance service incidents by chief complaint

This data is for the last two years in descending order for 2021. It reflects the number of emergency ambulance service incidents received, not number of patients and therefore actual patient numbers are higher. 

Reason for call Volume%Volume%Growth
Referral from a health practitioner77,14417.0%80,23816.6%4.0%
Chest pain39,3668.7%45,4689.4%15.5%
Falls and traumatic back injuries41,9799.2%43,4339.0%3.5%
Breathing problems36,0797.9%41,2748.5%14.4%
Sick person33,0717.3%35,7337.4%8.0%
Unconscious/passing out32,9717.3%33,5196.9%1.7%
Abdominal pain/problems20,2714.5%21,1754.4%4.5%
Traumatic injures18,1814.0%18,4983.8%1.7%
Traffic crash16,1083.5%17,0323.5%5.7%
Unknown problem16,8973.7%16,2143.3%-4.0%
Haemorrhage/ lacerations14,3753.2%14,9183.1%3.8%
Convulsion/fitting13,4783.0%14,3433.0%6.4%
Stroke (CVA)12,2062.7%13,7452.8%12.6%
Mental health/ suicide attempt8,4431.9%10,9752.3%30.0%
Overdose/ingestion/poisoning9,2832.0%9,8182.0%5.8%
Heart problems8,5621.9%9,6622.0%12.8%
Assault/rape9,1632.0%9,4622.0%3.3%
Other6,2441.4%6,8301.4%9.4%
Backpain – non traumatic5,8431.3%5,5211.1%-5.5%
Cardiac/respiratory arrest4,7911.1%4,7271.0%-1.3%
Allergies/rash/medical reaction/stings3,8350.8%4,3660.9%13.8%
Headache4,0770.9%4,0340.8%-1.1%
Diabetic problems3,6640.8%3,7700.8%2.9%
Pregnancy/childbirth/miscarriage2,8890.6%2,8760.6%-0.4%
Choking1,9960.4%2,2970.5%15.1%
Burns/explosion1,1690.3%1,1640.2%-0.4%
Stabbing/gunshot wound9970.2%1,1400.2%14.3%
Animal bites/attacks8210.2%8160.2%-0.6%
Eye problems/injuries5230.1%6290.1%20.3%
Carbon monoxide/inhalation/hazmat6060.1%6170.1%1.8%
Drowning/diving accident3560.1%3740.1%5.1%
Heat/ cold exposure1770.0%2150.0%21.5%
Industrial/machinery accidents1940.0%1770.0%-8.8%
Electrocutions1140.0%1040.0%-8.8%
Patient Transfer Services75,132n/a80,089n/a6.6%
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