期刊
RESUSCITATION
卷 79, 期 2, 页码 257-264出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2008.06.006
关键词
Ineffective breathing; Agonal breathing; Seizure protocol; Convulsion protocol; Fitting protocol; Medical Priority Dispatch System; Emergency medical services; Emergency medical dispatch; Acuity determination; Anoxic arrest seizures; Cardiac arrest
Objective: To investigate the impact of a new assessment question in the Medical, Priority Dispatch System (MPDS) seizure protocol on the ability of the Emergency Medical. Dispatchers (EMDs) to identify the presence of agonal, or ineffective breathing. Methods: A retrospective comparative study was conducted using two datasets-each representing two versions of the MPDS protocols (version 10.4 and version 11.2) at the London Ambulance Service (LAS). The before'' dataset (April 2004 to March 2005, version 10.4) did not have a specific assessment Key Question to identify the presence of irregular/agonal breathing. The question was added in the after dataset (April 2005 to March 2006, version 11.2). The datasets comprised the number of patients, calls(Is, responses, incidents, and outcome (i.e., cardiac arrest [CA] and blue-in [131]) parameters categorized using MPDS determinant codes. A distribution of these parameters was stratified by protocol version. Two-by-two contingency tables to determine association between (before and after'') protocols and CA outcome were generated. The likelihood of classifying CA outcome under the Not fitting now and breathing regularly (verified)''-protocol 12 ALPHA-level 1 (12-A-1) and combined DELTA descriptor codes, was established. Odds ratios (OR) and p-values at significance level of 0.05 cut-off were used to determine any significant associations. Results: For both datasets, the percentage of the emergency parameters increased with increasing determinant level from ALPHA to DELTA. The percentage of CA outcome in the 12-A-1 descriptor code in protocol version 11.2 was tower than that in version 10.4 (0.18% vs. 0.24%). Within protocol version 11.2, CA outcome was twice more likely in the combined DELTA descriptor codes when compared to other protocol 12 descriptor codes (OR(95%CI): 2.10(1.30, 1.40), p = 0.002). Conclusions: The addition of the new assessment question for breathing regularly to the dispatch question sequence in the MPDS seizure protocol provides a valuable tool. for identifying true cardiac arrest patients. Most of these cases appeared to be specifically captured by the new code 12 DELTA-level 3 (12-D-3): Irregular Breathing. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据