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- Hernborg, Martin N., et al.
(författare)
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First initiatives in prehospital care : Basing assessments on incomplete preliminary information
- 2020
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 0:6, s. 47-54
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Rationale and aim: Ambulance staff, i.e. registered nurses and assistant nurses, receive assignments from emergency dispatch centres including information on level of priority, address and patient’s care requirements. One problem is that the preliminary information the dispatcher gives to the ambulance staff may be incomplete. The purpose of this study was to determine how ambulance staff base their assessments on incomplete preliminary information when assessing care requirements.Methods: Fifteen ambulance staff working at seven ambulance stations were interviewed for this study. Interviews were transcribed and analysed using content analysis.Results: Incomplete preliminary information means that ambulance staff may be misdirected. This means that if the preliminary information from the dispatcher is incomplete, the ambulance staff need to reassess, and this is perceived to be difficult. Ambulance staff tend to stick to the first initiative that is taken after they receive an alert from the dispatcher.Conclusions: When ambulance staff receive incomplete preliminary information, they need to consider the possibility of conducting a reassessment. Based on the results, there is a need for new procedures to improve preparedness to conduct a reassessment after receiving incomplete preliminary information.
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| 2. |
- Rawshani, N., et al.
(författare)
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Association between use of pre-hospital ECG and 30-day mortality: A large cohort study of patients experiencing chest pain
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 248, s. 77-81
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the assessment of patients with chest pain, there is support for the use of pre-hospital ECG in the literature and in the care guidelines. Using propensity score methods, we aim to examine whether the mere acquisition of a pre-hospital ECG among patients with chest pain affects the outcome (30-day mortality). Methods: The association between pre-hospital ECG and 30-day mortality was studied in the overall cohort (n=13151), as well as in the one-to-one matched cohort with 2524 patients not examined with pre-hospital ECG and 2524 patients examined with pre-hospital ECG. Results: In the overall cohort, 21% (n=2809) did not undergo an ECG tracing in the pre-hospital setting. Among those who had pain during transport, 14% (n=1159) did not undergo a pre-hospital ECG while 32% (n=1135) of those who did not have pain underwent an ECG tracing. In the overall cohort, the OR for 30-day mortality in patients who had a pre-hospital ECG, as compared with those who did not, was 0.63 (95% CI 0.05-0.79; p < 0.001). In the matched cohort, the OR was 0.65 (95% CI 0.49-0.85; p < 0.001). Using the propensity score, in the overall cohort, the corresponding HR was 0.65 (95% CI 0.58-0.74). Conclusion: Using propensity score methods, we provide real-world data demonstrating that the adjusted risk of death was considerably lower among the cases in whoma pre-hospital ECG was used. The PH-ECG is underused among patients with chest discomfort and the mere acquisition of a pre-hospital ECG may reduce mortality. (C) 2017 Elsevier B.V. All rights reserved.
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