Andersson Henrik, Ullgren Andreas, Holmberg Mats, Karlsson Thomas, Herlitz Johan, Wireklint Sundström Birgitta
PreHospen - Centre for Prehospital Research, University of Borås, Sweden; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden.
Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden; Emergency Medical Service System, Skaraborg Hospital, Skövde, Sweden.
Int Emerg Nurs. 2017 Jul;33:43-47. doi: 10.1016/j.ienj.2016.12.001. Epub 2017 Apr 21.
Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome.
This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008-2010.
In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38% and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presence of dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis of acute myocardial infarction (AMI).
This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and serious diagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influence the ANs' assessment and that special education in cardiovascular nursing is required.
急性胸痛是院前急救患者的常见症状。因此,救护护士(ANs)具备识别症状和评估急性冠状动脉综合征(ACS)患者的能力至关重要。本研究的目的是探讨疑似ACS院前阶段呼吸困难、恶心和/或呕吐的发生率及其与患者预后的关联。
本研究采用定量设计,数据来源于医院记录以及一项先前的干预性研究(随机对照试验),该试验涵盖了2008 - 2010年瑞典西部的五个紧急医疗服务(EMS)系统。
共有1836名患者纳入干预性研究。38%的患者报告有呼吸困难,26%的患者有恶心和/或呕吐。呼吸困难的存在会增加一年内死亡的风险。恶心和/或呕吐的存在增加了最终诊断为急性心肌梗死(AMI)的可能性。
本研究表明,呼吸困难、恶心和/或呕吐会增加ACS患者的死亡风险和严重诊断的可能性。这意味着呼吸困难、恶心和/或呕吐应影响救护护士的评估,并且需要进行心血管护理方面的专项教育。