Acil servis tanıları ile paramediklerin ilk değerlendirme tanılarının karşılaştırılması.

Ramiz Yazıcı, Efe Demir Bala, Burak Bekgöz, Eyup Sari, Ayse Fethiye Basa Kalafat, Ozgur Omer Yildiz, Utku Murat Kalafat, Serkan Dogan
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Abstract

Background: This study aims to evaluate the accuracy and quality of prehospital assessments and preliminary diagnoses made by Emergency Medical Services (EMS) providers compared to the final diagnoses given by Emergency Department physicians in a metropolitan area.

Methods: This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately. Cases were categorized by EMS call time, reasons for EMS requests, age, gender, nationality, and weekday of hospital arrival to assess socioeconomic impacts and congestion patterns. The study included 2.528 pediatric cases, excluding patients aged 18 and older, those who refused EMS transfer, and cases resolved at the scene. Data analysis was conducted using IBM SPSS 27.0, with statistical significance set at p<0.05.

Results: The study included 2.528 cases. The data revealed that EMS providers had an average of 9.9±4.7 years of experience. In 1.839 cases (72.7%), the EMS provider was female, and in 689 cases (27.3%), the EMS provider was male. Patients had an average age of 9.2±5.8 years, with 1.173 (46.4%) being female and 1.355 (53.6%) being male. Preliminary diagnosis accuracy was higher in cases involving younger and male patients. Additionally, a lower preliminary diagnosis accuracy rate was observed during office hours (08: 00-15: 59) compared to non-office hours (16: 00-23: 59). The majority of EMS calls were for medical reasons (1,783 cases, 70.5%), followed by trauma-related calls (745 cases, 29.5%).

Conclusion: This study highlights the need for improved on-field training for EMS providers to enhance the accuracy and quality of prehospital assessments and preliminary diagnoses. The findings suggest that younger and male patients have higher preliminary diagnosis accuracy rates, and there is a noticeable decrease in accuracy during office hours, indicating potential areas for targeted training and protocol adjustments.

急救服务诊断与辅助医务人员初步评估诊断的比较。
背景:本研究旨在评估在大都市地区由急救医疗服务提供者进行的院前评估和初步诊断与急诊科医生最终诊断的准确性和质量:本研究旨在评估院前评估的准确性和质量,以及急救医疗服务(EMS)提供者做出的初步诊断与大都市地区急诊科医生做出的最终诊断的比较:这项回顾性观察研究利用了土耳其安卡拉市耶尼玛哈勒急救指挥中心 2021 年 1 月 1 日至 2022 年 12 月 31 日的记录。数据以病例而非单个患者为单位记录,重复急救入院的患者单独计算。病例按急救呼叫时间、急救请求原因、年龄、性别、国籍和抵达医院的工作日进行分类,以评估社会经济影响和拥堵模式。该研究包括 2528 例儿科病例,不包括 18 岁及以上的患者、拒绝急救转运的患者以及在现场解决的病例。数据分析使用 IBM SPSS 27.0 进行,统计显著性设置为 pResults:研究共包括 2528 个病例。数据显示,急救服务提供者的平均工作年限为(9.9±4.7)年。在 1 839 个病例(72.7%)中,急救服务提供者为女性,在 689 个病例(27.3%)中,急救服务提供者为男性。患者的平均年龄为(9.2±5.8)岁,其中 1.173 例(46.4%)为女性,1.355 例(53.6%)为男性。年龄较小和男性患者的初步诊断准确率较高。此外,与非办公时间(16:00-23:59)相比,办公时间(08:00-15:59)的初步诊断准确率较低。大多数急救呼叫都是出于医疗原因(1,783 例,70.5%),其次是与创伤有关的呼叫(745 例,29.5%):本研究强调了改善急救服务提供者现场培训的必要性,以提高院前评估和初步诊断的准确性和质量。研究结果表明,年轻和男性患者的初步诊断准确率较高,而上班时间的准确率则明显下降,这表明有可能需要进行有针对性的培训和协议调整。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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