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Background: Emergency medical service patients are a vulnerable population and the risk of mortality is considerable. In Denmark, healthcare professionals receive 112-emergency calls and assess the main reason for calling. The main aim was to investigate which of these reasons, i.e. which symptoms or mechanism of injury, contributed to short-term risk of death. Secondary aim was to study 1-30 day-mortality for each symptom/ injury., Methods: Historic population-based cohort study of emergency medical service patients calling 112 in the North Denmark Region between 01.01.2016-31.12.2018. We defined 1-day mortality as death on the same or the following day. The frequency of each symptom and cumulative number of deaths on day 1 and 30 together with 1- and 30-day mortality for each symptom/mechanism of injury is presented in proportions. Poisson regression with robust variance estimation was used to estimate incident rates (IR) of mortality with 95% confidence intervals (CI), crude and age and sex adjusted, mortality rates on day 1 per 100,000 person-year in the population., Results: The five most frequent reasons for calling 112 were "chest pain" (15.9%), "unclear problem" (11.9%), "accidents" (11.2%), "possible stroke" (10.9%), and "breathing difficulties" (8.3%). Four of these contributed to the highest numbers of deaths: "breathing difficulties" (17.2%), "unclear problem" (13.2%), "possible stroke" (8.7%), and "chest pain" (4.7%), all exceeded by "unconscious adult - possible cardiac arrest" (25.3%). Age and sex adjusted IR of mortality per 100,000 person-year was 3.65 (CI 3.01-4.44) for "unconscious adult - possible cardiac arrest" followed by "breathing difficulties" (0.45, CI 0.37-0.54), "unclear problem"(0.30, CI 0.11-0.17), "possible stroke"(0.13, CI 0.11-0.17) and "chest pain"(0.07, CI 0.05-0.09)., Conclusion: In terms of risk of death on the same day and the day after the 112-call, "unconscious adult/possible cardiac arrest" was the most deadly symptom, about eight times more deadly than "breathing difficulties", 12 times more deadly than "unclear problem", 28 times more deadly than "possible stroke", and 52 times more deadly than "chest pain". "Breathing difficulties" and "unclear problem" as presented when calling 112 are among the top three contributing to short term deaths when calling 112, exceeding both stroke symptoms and chest pain.

Objectives: To examine the severity and progression of acute illness or injury in children using vital signs obtained during ambulance transport and categorised according to a paediatric triage model., Design: A population-based historical cohort study using data from prehospital patient medical records linked to a national civil registration database., Setting: Emergency medical services providing ground-level transport in a mixed urban-rural region with three hospitals in Denmark., Participants: 25 039 events with patients aged <18 years attended by emergency medical services dispatched after a 1-1-2 emergency call during the years 2006-2018., Primary and Secondary Outcome Measures: Distribution of the first observed vital signs according to a paediatric triage model: heart rate, Glasgow Coma Score, respiratory rate, oxygen saturation and oxygen treatment, and proportion of patients progressing to a triage score with a lower level of urgency during ambulance transport., Results: The proportion of patients with the first observed vital signs outside the normal age-specific range was as follows: 33.6% for heart rate, 15.3% for Glasgow Coma Score, 17.4% for respiratory rate and 37.4% for oxygen saturation regardless of oxygen treatment. The proportion of patients progressing to a triage score with a lower level of urgency during transport varied with age: 146/354 (41.2%) for age 0-2 months, 440/986 (44.6%) for age 3-11 months, 1278/3212 (39.8%) for age 1-2 years, 967/2814 (34.4%) for age 3-7 years and 4029/13 864 (29.1%) for age 8-17 years (p<0.001). One-day mortality was 3.05 deaths per 1000 patient-days (95% CI 2.43 to 3.83)., Conclusions: One third of the patients' condition progressed to a triage score with a lower level of urgency during ambulance transport. Vital sign documentation in paediatric patients was incomplete, and educational initiatives should be taken to increase documentation of vital signs, especially in patients aged ≤2 years., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)