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首页> 外文期刊>Journal of Emergency Medicine, Trauma and Acute Care >Validation of the pre-hospital Qatar Early Warning Score (QEWS) to determine transport priority
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Validation of the pre-hospital Qatar Early Warning Score (QEWS) to determine transport priority

机译：验证院前卡塔尔预警分数（QEWS）以确定运输优先级

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Background: Ambulance Paramedics are dispatched to all calls while Critical Care Paramedic (CCP) units only attend potentially “life threatening” cases (Priority 1). Ambulance Paramedics (AP) triaged patients based on clinical judgment and experience creating a risk of Priority 1 under or over-triage. QEWS was designed to supplement priority decision-making process based on physiological values used as a trigger to identify patients with a potential risk of deterioration. The objective of this study was to undertake a comparison of the QEWS score calculated from retrospective vital signs data to that of the priority decision-making by ambulance crews. Methods: In our retrospective study, data entered into the Ambulance Service clinical database over a nine-month period before QEWS implementation was analysed for comparison of the priority decision made by the crew for each patient versus the calculated QEWS value based on the first set of six relevant vital signs (Heart rate, Respiratory rate, Systolic blood pressure, Temperature, Oxygen saturation, AVPU). Only cases with patients over 18 years old were included. Results: Of 34,908 retrieved cases, 27,915 (79.97%) had sufficient data to retrospectively determine QEWS. The mean age was 38.62 (+15.84) years and 21,453 (76.85%) were male patients. Priority decision-making correlated in 25,850 cases (92.6%), with 286 (1.11%) Priority 1 and 25,564 (98.89%) Priority 2 patients. In 1,662 cases (5.95%), QEWS retrospectively triaged patients higher and in 1.44%, QEWS triaged patients lower. Conclusions: Physiological variables are an established predictor of risk regarding a patient's condition. Hospital-based early warning scores have been validated and implemented successfully. Only one published pre-hospital scoring system has been validated for triage. Under-triage appears to be a common problem in medical patients. QEWS potentially could address this under-triage issue and appears to be a valid scoring system to implement for prioritising patients to routine or urgent transport, or CCP intervention.
机译：背景：所有呼叫均派遣了救护车救护人员，而重症监护救护人员（CCP）单位仅处理可能“危及生命”的案件（优先级1）。救护车医护人员（AP）根据临床判断和经验对患者进行了分类，从而产生了分类不足或分类过多的1级风险。 QEWS旨在根据生理学值来补充优先决策过程，而生理学值可作为触发条件来识别具有恶化风险的患者。这项研究的目的是比较根据回顾性生命体征数据计算出的QEWS得分与救护人员优先决策的得分。方法：在我们的回顾性研究中，分析了在实施QEWS之前的9个月内输入到救护车临床数据库中的数据，以比较机组人员针对每个患者做出的优先级决策与基于第一组数据计算出的QEWS值的比较。六个相关的生命体征（心率，呼吸率，收缩压，温度，血氧饱和度，AVPU）。仅包括18岁以上患者的病例。结果：在34,908例检索到的病例中，有27,915例（占79.97％）具有足够的数据来回顾性确定QEWS。平均年龄为38.62（+15.84）岁，男性为2​​1,453（76.85 ％）。优先决策与25,850例病例（92.6％）相关，其中286例（1.11％）属于优先1和25,564例（98.89％）与2例患者相关。在1,662例病例中（5.95％），QEWS回顾性分类的患者较高，而在1.44％（％）中，QEWS分类的患者较低。结论：生理变量是确定患者病情风险的既定指标。基于医院的预警分数已得到验证和成功实施。只有一种公开的院前评分系统已经过分流验证。分类不足似乎是医学患者中的常见问题。 QEWS可能可以解决这个分类不足的问题，并且似乎是一个有效的评分系统，可用于优先安排患者进行常规或紧急运输或CCP干预。

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