In 2018, the Graded EMS Care System (Gestuftes Versorgungssystem, GVS) was introduced into the Cologne emergency medical services (EMS). This is a classification tool (classes 0–7) for EMS personnel to classify patients at the scene in terms of their need for resources and the urgency of their treatment [4]. Since each GVS grade is assigned an EMS resource, this study examined a sample of around 65,000 incidents to determine whether the resources dispatched by the EMS control center were sufficient. This investigation became necessary because, with increasing numbers of incidents (+22% from 2018 to 2022 for Cologne’s EMS) and an emerging shortage of skilled workers, it is no longer possible to simply add more advanced life support (ALS) ambulances. Therefore, since 2018, basic life support (BLS) ambulances have been used for less urgent incidents. This study aimed to use the GVS classification to assess whether the use of BLS ambulances is medically justifiable in emergency medicine. It was found that a primarily dispatched BLS ambulance was sufficient in 96.7% of cases and a primarily dispatched ALS ambulance was sufficient in 99.6% of cases. The proportion of cases where a higher-value resource should have been dispatched according to the on-site personnel’s assessment was 3.3% for primary BLS ambulance dispatch and 0.4% for primary ALS ambulance dispatch. Upon reviewing these cases, a BLS ambulance would have been sufficient for 53.2% of the incidents, and in 15.5% of the cases, the patients could have been cared for by a general practitioner. The results allow the conclusions that (1) the use of the BLS ambulance for less urgent incidents is justifiable and (2) the dispatch center is able to recognize and serve life-threatening incidents with the strategy ‘when in doubt, dispatch the higher-value resource.’ The challenge for the dispatch center is to safely identify less urgent incidents and then also deploy the appropriate(less qualified) resource.
