Difficulty breathing: Agreement of paramedic and emergency physician diagnoses
Difficulty breathing: Agreement of paramedic and emergency physician diagnoses
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DOI：
10.1080/10903120500366888
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发表时间：
2006-01-01
影响因子：
2.4
通讯作者：
Waldron, Rachel L.
中科院分区：
文献类型：
--
作者：
Ackerman, Robert;Waldron, Rachel L.
目标。为了确定护理人员治疗因“呼吸困难”而叫了救护车的病人的诊断准确性。方法：研究方法。对一辆救护车在一年内发出的所有救护车呼叫报告进行回顾研究，并将“呼吸困难”的调度投诉送往医院。CALL报告中的护理诊断与急诊科(ED)医生的诊断进行了比较，后者被用作“金标准”。结果。总共审查了244份救护车报告。对于主诉“呼吸困难”的患者，医护人员诊断心脏疾病的敏感度和特异度分别为86.4%和86.6%，呼吸系统疾病的敏感度和特异度分别为71.4%和93.6%，其他疾病过程的敏感度和特异度分别为82.1%和91%。护理人员和急诊医生之间的评价者间一致性为81.1%，kappa为0.71，被解释为良好，接近优秀。结论。护理人员能够以中等程度的准确度识别被派往“呼吸困难”的患者的疾病进程类别。
Objective. To determine the diagnostic accuracy of paramedics treating patients who have called an ambulance for "difficulty breathing." Methods. A retrospective study of all ambulance call reports generated by one ambulance over a one-year period with the dispatch complaint of "difficulty breathing" taken to the hospital. The paramedic diagnosis on the call report was compared with the emergency department (ED) physician diagnosis, which was used as the "gold standard." Results. A total of 244 ambulance reports were reviewed. For patients complaining of "difficulty breathing," paramedics achieved 86.4% sensitivity and 86.6% specificity for diagnosing cardiac disease, 71.4% sensitivity and 93.6% specificity for respiratory disease, and 82.1% sensitivity and 91% specificity for other disease processes. There was an interrater agreement of 81.1% between paramedic and ED physician, producing a kappa of 0.71, interpreted as good, approaching excellent, agreement. Conclusion. Paramedics are able to identify the disease process category in patients dispatched as having " difficulty breathing," with a moderate degree of accuracy.