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首页> 外文期刊>Southern African Journal of Critical Care >The accuracy of Johannesburg-based ambulance personnel in identifying stroke
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The accuracy of Johannesburg-based ambulance personnel in identifying stroke

机译：约翰内斯堡的救护人员识别中风的准确性

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BACKGROUND: Stroke is a potentially life-threatening, time-dependent event that requires urgent management to reduce morbidity and mortality. It has been suggested that earlier recognition by ambulance personnel and transport to stroke centres may significantly reduce treatment delays. For this reason it is vitally important that ambulance personnel are able to accurately diagnose stroke METHODS: A series of vignettes were created that included images, video and audio displaying either signs or symptoms of stroke or those of another condition. Ambulance personnel were asked to review each vignette and state whether the patient described was suffering from a stroke or not. Further investigation was sought by requesting each individual to motivate their answer, mentioning upon what their diagnosis was based RESULTS: A total of 40 basic life support (BLS) and intermediate life support (ILS) personnel from different sites diagnosed 280 vignettes. BLS personnel were able to diagnose stroke with a sensitivity of 85.3% and a specificity of 89.9% (positive predictive value (PPV) 86.7%, negative predictive value (NPV) 88.8%), while ILS achieved a sensitivity of 98.2% and specificity of 94.0% (PPV 91.7%, NPV 98.8%). The combined sensitivity and specificity were 91.5% and 92.0%, respectively (PPV 89.2%, NPV 93.8%). In order to aid their diagnosis, only 5% of BLS and 18.34% of ILS utilised validated stroke screening tools CONCLUSION: Despite not using validated screening tools, the ambulance personnel sampled in this study were able to identify stroke with high accuracy. Further studies should be considered to identify how these diagnoses were reached in order to identify training needs.
机译：背景：中风是一种潜在的威胁生命的时间依赖性事件，需要紧急处理以降低发病率和死亡率。已经提出，由救护人员更早识别并转移到中风中心可以大大减少治疗延迟。因此，救护人员能够准确诊断中风至关重要。方法：创建了一系列小插曲，包括显示中风迹象或症状或其他状况的图像，视频和音频。要求救护人员检查每个小插图，并说明所描述的患者是否患有中风。结果要求：来自不同地点的40名基本生命支持（BLS）和中年生命支持（ILS）人员总共诊断出280个晕影，以寻求进一步的调查，要求每个人激发他们的答案，并提及他们的诊断依据。 BLS人员能够诊断出中风，敏感性为85.3％，特异性为89.9％（阳性预测值（PPV）为86.7％，阴性预测值（NPV）为88.8％），而ILS的敏感性为98.2％，特异性为94.0％（PPV 91.7％，NPV 98.8％）。组合敏感性和特异性分别为91.5％和92.0％（PPV 89.2％，NPV 93.8％）。为了帮助他们的诊断，只有5％的BLS和18.34％的ILS使用了经过验证的中风筛查工具。结论：尽管未使用经过验证的中风筛查工具，但本研究中采样的救护人员仍能够高精度地识别中风。为了确定培训需求，应考虑进行进一步的研究以确定如何达到这些诊断。

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