The Emergency Medical Service System in Gothenburg, Sweden.
Institute of Medicine, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy, Gothenburg University, SE-405 30 Gothenburg, Sweden.
Australas Emerg Care. 2021 Mar;24(1):61-66. doi: 10.1016/j.auec.2020.07.001. Epub 2020 Jul 15.
Patient with dizziness are challenging in prehospital care. The aim was to describe final diagnosis among patients assessed by EMS as suffering from dizziness with focus on time-critical conditions.
Consecutive patients assessed by an EMS clinician during 12 months in a single large EMS system in Gothenburg, Sweden (660,000 inhabitants), were assessed. The study comprised patients given ESS code 11 dizziness. The main end-point was the final diagnosis (ICD code).
There were 58,575 primary missions, of which 2,048 (3.5%) were assessed as ESS code 11 (dizziness). Of these, 161 (8%) were excluded. Among the remaining 1887 cases, there were 230 different ICD codes and 96 (5%) had a time-critical condition. The majority (88%) had a cerebrovascular disease. The most typical symptoms among time-critical conditions were an acute onset (63%) and nausea, vomiting (61%). When compared with non-time-critical conditions, those with time-critical conditions were older and had a higher median systolic blood pressure at EMS arrival.
Among primary missions by the EMS, 3.5% had dizziness. Of these, 5% had a time-critical condition and the majority had a cerebrovascular disease. Instruments to identify time-critical conditions among patients seen by EMS due to dizziness are required.
在院前护理中,头晕的患者具有挑战性。目的是描述通过 EMS 评估为头晕的患者的最终诊断,重点关注时间关键条件。
在瑞典哥德堡的一个单一大型 EMS 系统中,对 12 个月内由 EMS 临床医生评估的连续患者进行了评估。本研究包括被给予 ESS 代码 11 头晕的患者。主要终点是最终诊断(ICD 代码)。
共有 58575 次主要任务,其中 2048 次(3.5%)被评估为 ESS 代码 11(头晕)。其中,161 例(8%)被排除在外。在剩余的 1887 例中,有 230 个不同的 ICD 代码,96 例(5%)有时间关键条件。大多数(88%)患有脑血管疾病。时间关键条件中最典型的症状是急性发作(63%)和恶心、呕吐(61%)。与非时间关键条件相比,那些有时间关键条件的患者年龄更大,在 EMS 到达时的收缩压中位数更高。
在 EMS 的主要任务中,3.5%有头晕。其中,5%有时间关键条件,大多数患有脑血管疾病。需要识别 EMS 因头晕而就诊的患者中时间关键条件的仪器。