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首页> 外文期刊>Prehospital emergency care >Accuracy of stroke recognition by emergency medical dispatchers and paramedics--San Diego experience.
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Accuracy of stroke recognition by emergency medical dispatchers and paramedics--San Diego experience.

机译：紧急医疗调度员和护理人员对中风的识别准确性-圣地亚哥的经验。

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BACKGROUND: Prehospital personnel in Emergency Medical Service (EMS) systems have varying levels of accuracy in stroke recognition. Identifying the accuracy of emergency medical dispatcher using Medical Priority Dispatch Systems (MPDS) stroke protocol and paramedics may help understand the accuracy of stroke recognition in about 3000 emergency medical dispatch systems and prehospital systems world wide. OBJECTIVE: Our aim was to assess the accuracy of stroke identification in emergency medical dispatchers (EMD) with high compliance to MPDS protocol and paramedics using Cincinnati Prehospital Stroke Scale (CSS). METHODS: This was a retrospective observational study. Data was acquired from a computer assisted dispatch (CAD) system, a computerized paramedic record database and discharge diagnosis from billing records or stroke registry containing all stroke assessments of patients who presented to the participating study hospitals within 12 hours of symptom onset. We included patients 18 years or older, identified as having stroke by EMD and city agency paramedics. We excluded patients taken to hospitals not participating in the study, patients with a dispatch determinant of Stroke (card 28) not transported by City EMS agency (SDMSE) to participating hospitals, patients in the stroke registry not transported by SDMSE or patients with no final outcome data. A stroke neurologist or hospital discharge diagnosis of stroke (physician diagnosis) was used to determine the sensitivity and predictive values of EMD and paramedic recognition of stroke. RESULTS: Of 882 patients with a dispatch determinant of stroke using MPDS Stroke protocol, 367 had a final discharge diagnosis of stroke. This gives a sensitivity of 83% and a positive predictive value of 42% for EMD using MPDS Stroke protocol. Of 477 patients with a paramedic assessment of stroke using CSS, 193 had a final discharge diagnosis of stroke. This gives a sensitivity of 44% and a PPV of 40% for paramedics using CSS. CONCLUSIONS: In our EMS system, EMD using MPDS Stroke protocol with a high compliance has a higher sensitivity than paramedics using CSS.
机译：背景：紧急医疗服务（EMS）系统中的院前人员在中风识别方面的准确性水平各不相同。使用医疗优先调度系统（MPDS）中风协议和护理人员来识别紧急医疗调度员的准确性，可能有助于了解全球约3000个紧急医疗调度系统和院前系统中中风识别的准确性。目的：我们的目的是使用辛辛那提院前卒中量表（CSS）评估符合MPDS协议和护理人员要求的紧急医疗调度员（EMD）的卒中识别准确性。方法：这是一项回顾性观察研究。数据从计算机辅助调度（CAD）系统，计算机化的护理人员记录数据库中获取，并从账单记录或中风注册表中获得出院诊断，其中包含在症状发作后12小时内就诊给参与研究医院的患者的所有中风评估。我们纳入了18岁或18岁以上的患者，这些患者被EMD和市政机构医护人员鉴定为中风。我们排除了不参加研究的医院患者，中风急症决定因素（卡28）未由市EMS机构（SDMSE）运送到参与医院的患者，中风登记册中未由SDMSE运送的患者或没有最终诊断的患者结果数据。中风神经科医生或中风医院出院诊断（医师诊断）用于确定EMD的敏感性和预测值以及中风的护理人员识别。结果：在882名采用MPDS Stroke方案确定卒中分派的患者中，有367名最终诊断为卒中。使用MPDS Stroke协议，EMD的灵敏度为83％，阳性预测值为42％。在使用CSS对中风进行护理人员评估的477名患者中，有193名最终诊断为中风。对于使用CSS的医护人员来说，灵敏度为44％，PPV为40％。结论：在我们的EMS系统中，使用MPDS Stroke协议且符合性较高的EMD比使用CSS的护理人员具有更高的敏感性。

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