# Isolated emergency medical incidents in the practice of Polish firefighters in 2020–2023: analysis of intervention causes

## TL;DR

This study analyzed emergency medical incidents handled by Polish firefighters from 2020 to 2023, identifying patterns and factors influencing response times and incident types.

## Contribution

The study provides a detailed nationwide analysis of IEMIs in Poland, revealing temporal and regional trends not previously documented.

## Key findings

- IEMIs accounted for 35% of interventions, with significant regional and yearly variations in duration and frequency.
- Incident counts correlated with population and urbanization levels, but not with geographic area.
- Seasonal peaks in Q4 were observed for cardiac arrest and dyspnoea, but not for other conditions like hemorrhage or psychiatric disorders.

## Abstract

To quantify and characterize Isolated Emergency Medical Incidents (IEMIs) managed by National Firefighting and Rescue System (NFRS) units in Poland in 2020–2023 and to identify temporal and regional patterns.

Retrospective nationwide analysis of anonymised State Fire Service decision-support records. Inclusion required NFRS arrival before EMS, documented direct actions, duration over 1 min, and dates 01.01.2020–31.12.2023. Descriptive statistics were compiled at the voivodeship level. Group differences were tested with Kruskal–Wallis and Dunn–Bonferroni procedures. Associations were examined with Spearman correlation. Visualizations included heat maps, box plots, and a choropleth. Seasonality was assessed by calendar quarter.

Approximately 2.25 million interventions were undertaken; medical rescue comprised about 35%. Regional heterogeneity was significant (χ2 = 46.72; p < 0.001). Mean IEMI duration differed by year (χ2 = 28.35; p < 0.001), peaking in 2021 and declining in 2022–2023 (medians 13–12 min). Pairwise contrasts showed 2020 > 2022 (p = 0.015), 2020 > 2023 (p = 0.001), 2021 > 2022 (p = 0.001), and 2021 > 2023 (p < 0.001). Minimum time did not correlate with the mean (ρ = 0.05; p = 0.7); maximum time did (ρ = 0.55; p < 0.001). Incident counts correlated with population (ρ = 0.518) and urbanization (ρ = 0.446), modestly with number of EMS teams (ρ = 0.396), and weakly with area (ρ = 0.277). Q4 increases were consistent for cardiac arrest, unconsciousness, and dyspnoea; hemorrhage, choking, psychiatric disorders, and other showed no seasonality. Annual totals did not differ (H(3) = 1.83; p = 0.608).

IEMIs form a stable share of NFRS activity, dominated by cardiac arrest, syncope, trauma, and neurological disorders, with a Q4 peak. Seasonal readiness in October–December, targeted QFA training on CPR/AED, resource allocation by per capita and urbanization metrics, early activation thresholds, standardized winter workflows, and quarterly quality monitoring may improve timeliness and reduce demand.