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The final assessment and its association with field assessment in patients who were transported by the emergency medical service.
Department of Molecular and Clinical Medicine, University of Gothenburg . (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)
Department of Anaesthesiology and Intensive Care and Department of Medical and Health Sciences, Linköping University.
School of Education, Health and Social Studies, Dalarna University .
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2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1, article id 111Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In patients who call for the emergency medical service (EMS), there is a knowledge gap with regard to the final assessment after arriving at hospital and its association with field assessment.

AIM: In a representative population of patients who call for the EMS, to describe a) the final assessment at hospital discharge and b) the association between the assessment in the field and the assessment at hospital discharge.

METHODS: Thirty randomly selected patients reached by a dispatched ambulance each month between 1 Jan and 31 Dec 2016 in one urban, one rural and one mixed ambulance organisation in Sweden took part in the study. The exclusion criteria were age < 18 years, dead on arrival, transport between health-care facilities and secondary missions. Each patient received a unique code based on the ICD code at hospital discharge and field assessment.

RESULTS: In all, 1080 patients took part in the study, of which 1076 (99.6%) had a field assessment code. A total of 894 patients (83%) were brought to a hospital and an ICD code (ICD-10-SE) was available in 814 patients (91% of these cases and 76% of all cases included in the study). According to these ICD codes, the most frequent conditions were infection (15%), trauma (15%) and vascular disease (9%). The most frequent body localisation of the condition was the thorax (24%), head (16%) and abdomen (13%). In 118 patients (14% of all ICD codes), the condition according to the ICD code was judged as time critical. Among these cases, field assessment was assessed as potentially appropriate in 75% and potentially inappropriate in 12%.

CONCLUSION: Among patients reached by ambulance in Sweden, 83% were transported to hospital and, among them, 14% had a time-critical condition. In these cases, the majority were assessed in the field as potentially appropriate, but 12% had a potentially inappropriate field assessment. The consequences of these findings need to be further explored.

Place, publisher, year, edition, pages
2018. Vol. 26, no 1, article id 111
Keywords [en]
Assessment, Diagnose, Prehospital
National Category
Other Medical Sciences not elsewhere specified
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-15560DOI: 10.1186/s13049-018-0579-xPubMedID: 30587210OAI: oai:DiVA.org:hb-15560DiVA, id: diva2:1274143
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Prehospital patientsäkerhetAvailable from: 2018-12-28 Created: 2018-12-28 Last updated: 2019-01-03Bibliographically approved

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Axelsson, ChristerHerlitz, JohanAndersson Hagiwara, Magnus

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