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Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study
BACKGROUND: After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary objective of this study was to assess the reliability of the current EMS protocol by...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137918/ https://www.ncbi.nlm.nih.gov/pubmed/30217231 http://dx.doi.org/10.1186/s13049-018-0540-z |
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author | Breeman, Wim Poublon, Nathan A. Verhofstad, Michael H. J. Van Lieshout, Esther M. M. |
author_facet | Breeman, Wim Poublon, Nathan A. Verhofstad, Michael H. J. Van Lieshout, Esther M. M. |
author_sort | Breeman, Wim |
collection | PubMed |
description | BACKGROUND: After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary objective of this study was to assess the reliability of the current EMS protocol by determining whether the decision not to transport the patient to a care provider was correct or not. METHODS: Adults receiving on-scene medical care by an EMS rapid responder or full team without transport to the hospital were included in this prospective observational study. The primary outcome measure was secondary consultation within 24 h after an on-scene EMS evaluation without transport for the same or a closely related complaint. The secondary outcome measures were patient satisfaction, type of secondarily consulted health care provider, provisional and definitive diagnosis, and correctness of the EMS members’ decision to provide on-scene medical care without transport. RESULTS: Of the 1095 participating patients, 271 (24.7%) patients requested secondary medical attention for the same complaint. This percentage was significantly larger in incidents attended by an ambulance team than by a rapid responder (N = 248 (26.5%) vs. N = 23 (14.4%); p < 0.05). In eleven (1.0%) cases an urgent medical diagnosis requiring admission was missed. A total of 873 (79.7%) patients were satisfied with the decision not to be transported. In 44 (4.0%) cases the EMS nurse’s decision was rated incorrect since the patient needed help contradictory to the EMS nurse’s recommendation. CONCLUSIONS: The data show that EMS nurses can effectively examine patients, but a low threshold of referral for consultation should be considered because one in four patients requested secondary medical attention for the same complaint(s) again. However, due to a low response rate (11.3%) more research is needed to further determine the safety of the current EMS protocol. TRIAL REGISTRATION: Not applicable. |
format | Online Article Text |
id | pubmed-6137918 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61379182018-09-15 Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study Breeman, Wim Poublon, Nathan A. Verhofstad, Michael H. J. Van Lieshout, Esther M. M. Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: After on-scene examination and /or treatment, emergency medical services (EMS) nurses must decide whether the patient requires further assessment or treatment, most frequently in a hospital. The primary objective of this study was to assess the reliability of the current EMS protocol by determining whether the decision not to transport the patient to a care provider was correct or not. METHODS: Adults receiving on-scene medical care by an EMS rapid responder or full team without transport to the hospital were included in this prospective observational study. The primary outcome measure was secondary consultation within 24 h after an on-scene EMS evaluation without transport for the same or a closely related complaint. The secondary outcome measures were patient satisfaction, type of secondarily consulted health care provider, provisional and definitive diagnosis, and correctness of the EMS members’ decision to provide on-scene medical care without transport. RESULTS: Of the 1095 participating patients, 271 (24.7%) patients requested secondary medical attention for the same complaint. This percentage was significantly larger in incidents attended by an ambulance team than by a rapid responder (N = 248 (26.5%) vs. N = 23 (14.4%); p < 0.05). In eleven (1.0%) cases an urgent medical diagnosis requiring admission was missed. A total of 873 (79.7%) patients were satisfied with the decision not to be transported. In 44 (4.0%) cases the EMS nurse’s decision was rated incorrect since the patient needed help contradictory to the EMS nurse’s recommendation. CONCLUSIONS: The data show that EMS nurses can effectively examine patients, but a low threshold of referral for consultation should be considered because one in four patients requested secondary medical attention for the same complaint(s) again. However, due to a low response rate (11.3%) more research is needed to further determine the safety of the current EMS protocol. TRIAL REGISTRATION: Not applicable. BioMed Central 2018-09-14 /pmc/articles/PMC6137918/ /pubmed/30217231 http://dx.doi.org/10.1186/s13049-018-0540-z Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Breeman, Wim Poublon, Nathan A. Verhofstad, Michael H. J. Van Lieshout, Esther M. M. Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title | Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title_full | Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title_fullStr | Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title_full_unstemmed | Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title_short | Safety of on-scene medical care by EMS nurses in non-transported patients: a prospective, observational study |
title_sort | safety of on-scene medical care by ems nurses in non-transported patients: a prospective, observational study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137918/ https://www.ncbi.nlm.nih.gov/pubmed/30217231 http://dx.doi.org/10.1186/s13049-018-0540-z |
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