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Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

INTRODUCTION: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and lo...

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Autores principales: Mehrara, Mostafa, Tavakoli, Nader, Fathi, Marzieh, Mahshidfar, Babak, Zare, Mohammad Amin, Asadi, Azita, Hosseinzadeh, Saeedeh, Safdarian, Mehdi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shahid Beheshti University of Medical Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325911/
https://www.ncbi.nlm.nih.gov/pubmed/28286847
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author Mehrara, Mostafa
Tavakoli, Nader
Fathi, Marzieh
Mahshidfar, Babak
Zare, Mohammad Amin
Asadi, Azita
Hosseinzadeh, Saeedeh
Safdarian, Mehdi
author_facet Mehrara, Mostafa
Tavakoli, Nader
Fathi, Marzieh
Mahshidfar, Babak
Zare, Mohammad Amin
Asadi, Azita
Hosseinzadeh, Saeedeh
Safdarian, Mehdi
author_sort Mehrara, Mostafa
collection PubMed
description INTRODUCTION: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC). METHOD: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards. RESULTS: 101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor. CONCLUSION: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.
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spelling pubmed-53259112017-03-10 Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report Mehrara, Mostafa Tavakoli, Nader Fathi, Marzieh Mahshidfar, Babak Zare, Mohammad Amin Asadi, Azita Hosseinzadeh, Saeedeh Safdarian, Mehdi Emerg (Tehran) Brief Report INTRODUCTION: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC). METHOD: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards. RESULTS: 101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor. CONCLUSION: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting. Shahid Beheshti University of Medical Sciences 2017 2017-01-11 /pmc/articles/PMC5325911/ /pubmed/28286847 Text en © Copyright (2017) Shahid Beheshti University of Medical Sciences This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Brief Report
Mehrara, Mostafa
Tavakoli, Nader
Fathi, Marzieh
Mahshidfar, Babak
Zare, Mohammad Amin
Asadi, Azita
Hosseinzadeh, Saeedeh
Safdarian, Mehdi
Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title_full Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title_fullStr Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title_full_unstemmed Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title_short Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
title_sort protocol adherence in prehospital medical care provided for patients with chest pain and loss of consciousness; a brief report
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325911/
https://www.ncbi.nlm.nih.gov/pubmed/28286847
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