Recognition of climate-related risks for prehospital emergency medical service and emergency department in Finland - A Delphi study

Background: Emergency departments (ED) and prehospital emergency medical services (EMS) will experience new or increasing challenges due to the changing climate. The aims of this study was to add knowledge about these challenges in Finland and to help EMS and ED operators to prepare for the effects of climate change. Methods: A two-round Delphi study was conducted. Ten participants expressed their views of climate changerelated challenges currently and in the future, and how to prepare for challenges ahead. First-round questions based on the literature search about the climate-related impacts on EMS and ED. The stage one data was analysed by thematic analysis, which generated the second-round survey where the probability of the statements was estimated. Results: Various climate change-related challenges were recognized such as negative health impacts, the increased workload, difficulties with the EMS operations and problems with the functions of society. Preparation of action plans was considered important in case for incidents and emergencies. Conclusion: The study indicated that climate change may cause various challenges for EMS and ED in Finland. To meet the future challenges, it is important to identify potential future risks and create plans to manage them. Further studies are needed to create climate resilient healthcare systems.