{"title":"护理人员早期休克识别的准确性：日本一项多中心前瞻性观察研究。","authors":"Rina Tanohata, Katsutoshi Saito, Takehiko Nagano, Hidenobu Ochiai","doi":"10.2185/jrm.2024-053","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Early recognition of shock status by paramedics significantly affects patient prognosis; however, its accuracy remains unclear. This study assessed the diagnostic accuracy of paramedics in classifying shock and the characteristics of misdiagnoses.</p><p><strong>Materials and methods: </strong>This multicenter prospective observational study compared the on-scene shock diagnoses of paramedics between July 2022 and June 2023 with those of physicians upon hospital arrival.</p><p><strong>Results: </strong>The overall diagnostic accuracy for shock revealed substantial agreement (k=0.64), whereas diagnosis by category ranged from slight to moderate agreement (k=0.11-0.51). Patients without systolic hypotension were more frequently missed during diagnosis.</p><p><strong>Conclusions: </strong>Enhanced clinical education is needed to improve the accuracy of shock diagnosis by paramedics.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"20 2","pages":"125-131"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962191/pdf/","citationCount":"0","resultStr":"{\"title\":\"Accuracy of early shock recognition by paramedics: a multicenter prospective observational study in Japan.\",\"authors\":\"Rina Tanohata, Katsutoshi Saito, Takehiko Nagano, Hidenobu Ochiai\",\"doi\":\"10.2185/jrm.2024-053\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Early recognition of shock status by paramedics significantly affects patient prognosis; however, its accuracy remains unclear. This study assessed the diagnostic accuracy of paramedics in classifying shock and the characteristics of misdiagnoses.</p><p><strong>Materials and methods: </strong>This multicenter prospective observational study compared the on-scene shock diagnoses of paramedics between July 2022 and June 2023 with those of physicians upon hospital arrival.</p><p><strong>Results: </strong>The overall diagnostic accuracy for shock revealed substantial agreement (k=0.64), whereas diagnosis by category ranged from slight to moderate agreement (k=0.11-0.51). Patients without systolic hypotension were more frequently missed during diagnosis.</p><p><strong>Conclusions: </strong>Enhanced clinical education is needed to improve the accuracy of shock diagnosis by paramedics.</p>\",\"PeriodicalId\":73939,\"journal\":{\"name\":\"Journal of rural medicine : JRM\",\"volume\":\"20 2\",\"pages\":\"125-131\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962191/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of rural medicine : JRM\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2185/jrm.2024-053\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of rural medicine : JRM","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2185/jrm.2024-053","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Accuracy of early shock recognition by paramedics: a multicenter prospective observational study in Japan.
Objective: Early recognition of shock status by paramedics significantly affects patient prognosis; however, its accuracy remains unclear. This study assessed the diagnostic accuracy of paramedics in classifying shock and the characteristics of misdiagnoses.
Materials and methods: This multicenter prospective observational study compared the on-scene shock diagnoses of paramedics between July 2022 and June 2023 with those of physicians upon hospital arrival.
Results: The overall diagnostic accuracy for shock revealed substantial agreement (k=0.64), whereas diagnosis by category ranged from slight to moderate agreement (k=0.11-0.51). Patients without systolic hypotension were more frequently missed during diagnosis.
Conclusions: Enhanced clinical education is needed to improve the accuracy of shock diagnosis by paramedics.
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