Availability and Accuracy of EMS Information about Chronic Health and Medications in Cardiac Arrest.
Availability and Accuracy of EMS Information about Chronic Health and Medications in Cardiac Arrest.
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EMS有关心脏骤停慢性健康和药物的信息的可用性和准确性。
DOI：
10.5811/westjem.2017.5.33198
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Rea TD
中科院分区：
文献类型：
--
作者：
Foster A;Florea V;Fahrenbruch C;Blackwood J;Rea TD
紧急医疗服务（EMS）提供的有关患者慢性健康状况或药物治疗的现场信息可以帮助指导患者护理或用于调查结果差异。然而，鲜为人知的是，在紧急情况下，特别是当病人不能作为一个信息资源的现场可用性或准确性的信息的慢性健康状况或慢性药物治疗。我们评估了院外心脏骤停（OHCA）患者中特定慢性健康状况和药物治疗的院前可用性和准确性。该研究是一项回顾性队列研究，研究对象为2007年1月1日至2013年12月31日在一个大都市县接受EMS治疗的室颤OHCA成人。该研究旨在确定EMS确定选定的慢性健康状况和药物治疗的可用性和准确性。我们使用两种不同的来源评估了“任何心脏病”、充血性心力衰竭（CHF）和糖尿病的慢性健康状况以及β受体阻滞剂和袢利尿剂的药物治疗：1）EMS报告，2）OHCA事件的医院记录。由于医院信息被认为是金标准，我们将主要分析限制在住院患者。在1，496名最初合格的患者中，387名患者无法复苏，并在现场被宣布死亡，1名患者由于医生的生命维持治疗（POLST）命令而在现场存活，125名患者在急诊室死亡（n=125），983名患者入院。1,496人中共有832人（55.6%）具有两种数据来源进行比较，并组成了主要分析组。以病历为金标准，EMS对既往心脏病的敏感性为0.79（304/384），特异性为0.88（218/248），对CHF的敏感性为0.45（47/105），特异性为0.87（477/516）;糖尿病敏感性0.71（143/201），特异性0.98（416/424），β受体阻滞剂敏感性0.70（118/169），特异性0.94（273/290）;对袢利尿剂敏感性0.70（62/89），特异性0.97（358/370）。在OHCA的这个队列中，许多患者可以获得基于EMS确定的选定慢性健康状况和药物治疗的信息，通常显示中等敏感性和更高的特异性。
Field information available to emergency medical services (EMS) about a patient’s chronic health conditions or medication therapies could help direct patient care or be used to investigate outcome disparities. However, little is known about the field availability or accuracy of information of chronic health conditions or chronic medication treatments in emergent circumstances, especially when the patient cannot serve as an information resource. We evaluated the prehospital availability and accuracy of specific chronic health conditions and medication treatments among out-of-hospital cardiac arrest (OHCA) patients. The investigation was a retrospective cohort study of adult persons suffering ventricular fibrillation OHCA treated by EMS in a large metropolitan county from January 1, 2007, to December 31, 2013. The study was designed to determine the availability and accuracy of EMS ascertainment of selected chronic health conditions and medication treatments. We evaluated chronic health conditions of “any heart disease,” congestive heart failure (CHF), and diabetes and medication treatments of beta blockers and loop diuretics using two distinct sources: 1) EMS report, and 2) hospital record specific to the OHCA event. Because hospital information was considered the gold standard, we restricted the primary analysis to those who were admitted to hospital. Of the 1,496 initially eligible patients, 387 could not be resuscitated and were pronounced dead in the field, one patient was left alive at scene due to Physician’s Orders for Life-sustaining Treatment (POLST) orders, 125 expired in the emergency department (n=125), and 983 were admitted to hospital. A total of 832 of 1,496 (55.6%) had both sources of data for comparison and comprised the primary analytic group. Using the hospital record as the gold standard, EMS ascertainment had a sensitivity of 0.79 (304/384) and a specificity of 0.88 (218/248) for any prior heart disease; sensitivity 0.45 (47/105) and specificity 0.87 (477/516) for CHF; sensitivity 0.71 (143/201) and specificity 0.98 (416/424) for diabetes; sensitivity 0.70 (118/169) and specificity 0.94 (273/290) for beta blockers; sensitivity 0.70 (62/89) and specificity 0.97 (358/370) for loop diuretics. In this cohort of OHCA, information about selected chronic health conditions and medication treatments based on EMS ascertainment was available for many patients, generally revealing moderate sensitivity and greater specificity.
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影响因子：
37.8
作者：
Neumar, Robert W.;Shuster, Michael;Hazinski, Mary Fran
通讯作者：
Hazinski, Mary Fran
影响因子：
3.1
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通讯作者：
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影响因子：
5.4
作者：
Stecker, Eric C.;Teodorescu, Carmen;Chugh, Sumeet S.
通讯作者：
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