CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Initial assessment, level of care and outcome among children who were seen by emergency medical services: a prospective observational study.
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Health Metrics Unit, Sahlgrenska Academy, University of Gothenburg.
Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg.
2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1, article id 88Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The assessment of children in the Emergency Medical Service (EMS) is infrequent representing 5.4% of the patients in an urban area in the western part of Sweden. In Sweden, patients are assessed on scene by an EMS nurse whom independently decides on interventions and level of care. To aid the EMS nurse in the assessment a triage instrument, Rapid Emergency Triage and Treatment System-paediatrics (RETTS-p) developed for Emergency Department (ED) purpose has been in use the last 5 years. The aim of this study was to evaluate the EMS nurse assessment, management, the utilisation of RETTS-p and patient outcome.

METHODS: A prospective, observational study was performed on 651 children aged < 16 years from January to December 2016. Statistical tests used in the study were Mann-Whitney U test, Fisher's exact test and Spearman's rank statistics.

RESULTS: The dispatch centre indexed life-threatening priority in 69% of the missions but, of all children, only 6.1% were given a life threatening RETTS-p red colour by the EMS nurse. A total of 69.7% of the children were transported to the ED and, of these, 31.7% were discharged without any interventions. Among the non-conveyed patients, 16 of 197 (8.1%) visited the ED within 72 h but only two were hospitalised. Full triage, including five out of five vital signs measurements and an emergency severity index, was conducted in 37.6% of all children. A triage colour was not present in 146 children (22.4%), of which the majority were non-conveyed. The overall 30-day mortality rate was 0.8% (n = 5) in children 0-15 years.

CONCLUSIONS: Despite the incomplete use of all vital signs according to the RETTS-p, the EMS nurse assessment of children appears to be adapted to the clinical situation in most cases and the patients appear to be assessed to the appropriate level of care but indicating an over triage. It seems that the RETTS-p with full triage is used selectively in the pre-hospital assessment of children with a risk of death during the first 30 days of less than 1%.

Place, publisher, year, edition, pages
2018. Vol. 26, no 1, article id 88
Keywords [en]
Children, EMS nurse, Level of care, Patient safety, Pre-hospital assessment, Triage
National Category
Other Clinical Medicine
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-15531DOI: 10.1186/s13049-018-0560-8ISI: 000447850100002PubMedID: 30340502Scopus ID: 2-s2.0-85055076048OAI: oai:DiVA.org:hb-15531DiVA, id: diva2:1273263
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2019-01-14Bibliographically approved

Open Access in DiVA

fulltext(513 kB)2 downloads
File information
File name FULLTEXT01.pdfFile size 513 kBChecksum SHA-512
f453a3dee84b810469a87361081535bd99a210f44a6002c329aa433a1ac4e0c42757b2bb38b23a8c48366a6e68f9163d8892d15422ac0c494e9db2b3384a6ba6
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records BETA

Herlitz, Johan

Search in DiVA

By author/editor
Herlitz, Johan
By organisation
Faculty of Caring Science, Work Life and Social Welfare
In the same journal
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Other Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar
Total: 2 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 3 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf