Cargando…
Implementing a paediatric early warning score into pre-hospital practice
AIM: This study addressed a desire by ambulance clinicians for additional education in the examination and assessment of the unwell child; it also explored whether ambulance clinicians could use a paediatric early warning score (PEWS) safely and effectively in the pre-hospital arena. METHODS: A smal...
Autor principal: | |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The College of Paramedics
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706775/ https://www.ncbi.nlm.nih.gov/pubmed/33328828 http://dx.doi.org/10.29045/14784726.2019.06.4.1.42 |
_version_ | 1783617220618747904 |
---|---|
author | Rolls, Martin |
author_facet | Rolls, Martin |
author_sort | Rolls, Martin |
collection | PubMed |
description | AIM: This study addressed a desire by ambulance clinicians for additional education in the examination and assessment of the unwell child; it also explored whether ambulance clinicians could use a paediatric early warning score (PEWS) safely and effectively in the pre-hospital arena. METHODS: A small-scale study introduced a validated PEWS into pre-hospital practice. The paediatric observations priority score (POPS) combines physiological observations with clinicians’ review. POPS uses a range of proxy measures such as work of breathing, alertness, gut feeling and known high-risk factors, to further refine the scoring. Based on a sample of over 24,000 patients, POPS has been validated for use in emergency departments (EDs). POPS can identify potentially critically unwell children as well as those fit for discharge without hospital admission, the fundamental purpose of an ED. Study participants were surveyed before and after the trial period in order to examine self-reported scores in confidence and competence levels for the child in pain, the breathless child, the child with a decreased level of consciousness, the febrile child and the seriously injured child. Completed patient report forms (PRFs) were returned to the principal investigator for further analysis. PRFs were re-distributed among participants for rescoring. Once rescoring was completed, the PRFs were returned to the principal investigator for calculation of interrater reliability. Participants remained anonymous for the survey. RESULTS: Interrater reliability (Kappa coefficient) was calculated as 0.401, which is considered moderate agreement. As POPS rose, variance decreased. Lower POPS had variance, but these patients were lower acuity. Equal scoring in the main was reliable. CONCLUSION: For a cohort of ambulance clinicians, POPS was found to be safe and effective. Self-reported levels in confidence and competence improved in all patient presentations when comparing before and after the trial period (Table 1). |
format | Online Article Text |
id | pubmed-7706775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The College of Paramedics |
record_format | MEDLINE/PubMed |
spelling | pubmed-77067752020-12-15 Implementing a paediatric early warning score into pre-hospital practice Rolls, Martin Br Paramed J College of Paramedics’ National Conference 2019: Research abstracts AIM: This study addressed a desire by ambulance clinicians for additional education in the examination and assessment of the unwell child; it also explored whether ambulance clinicians could use a paediatric early warning score (PEWS) safely and effectively in the pre-hospital arena. METHODS: A small-scale study introduced a validated PEWS into pre-hospital practice. The paediatric observations priority score (POPS) combines physiological observations with clinicians’ review. POPS uses a range of proxy measures such as work of breathing, alertness, gut feeling and known high-risk factors, to further refine the scoring. Based on a sample of over 24,000 patients, POPS has been validated for use in emergency departments (EDs). POPS can identify potentially critically unwell children as well as those fit for discharge without hospital admission, the fundamental purpose of an ED. Study participants were surveyed before and after the trial period in order to examine self-reported scores in confidence and competence levels for the child in pain, the breathless child, the child with a decreased level of consciousness, the febrile child and the seriously injured child. Completed patient report forms (PRFs) were returned to the principal investigator for further analysis. PRFs were re-distributed among participants for rescoring. Once rescoring was completed, the PRFs were returned to the principal investigator for calculation of interrater reliability. Participants remained anonymous for the survey. RESULTS: Interrater reliability (Kappa coefficient) was calculated as 0.401, which is considered moderate agreement. As POPS rose, variance decreased. Lower POPS had variance, but these patients were lower acuity. Equal scoring in the main was reliable. CONCLUSION: For a cohort of ambulance clinicians, POPS was found to be safe and effective. Self-reported levels in confidence and competence improved in all patient presentations when comparing before and after the trial period (Table 1). The College of Paramedics 2019-06-01 2019-06-01 /pmc/articles/PMC7706775/ /pubmed/33328828 http://dx.doi.org/10.29045/14784726.2019.06.4.1.42 Text en © 2019 The Author(s) https://creativecommons.org/licenses/by/2.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | College of Paramedics’ National Conference 2019: Research abstracts Rolls, Martin Implementing a paediatric early warning score into pre-hospital practice |
title | Implementing a paediatric early warning score into pre-hospital practice |
title_full | Implementing a paediatric early warning score into pre-hospital practice |
title_fullStr | Implementing a paediatric early warning score into pre-hospital practice |
title_full_unstemmed | Implementing a paediatric early warning score into pre-hospital practice |
title_short | Implementing a paediatric early warning score into pre-hospital practice |
title_sort | implementing a paediatric early warning score into pre-hospital practice |
topic | College of Paramedics’ National Conference 2019: Research abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706775/ https://www.ncbi.nlm.nih.gov/pubmed/33328828 http://dx.doi.org/10.29045/14784726.2019.06.4.1.42 |
work_keys_str_mv | AT rollsmartin implementingapaediatricearlywarningscoreintoprehospitalpractice |