Alghamdi Abdulrhman, Alshibani Abdullah, Binhotan Meshary, Alsabani Mohmad, Alotaibi Tareq, Alharbi Rayan, Alabdali Abdullah
Emergency Medical Services Department, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
J Multidiscip Healthc. 2023 Jul 26;16:2101-2107. doi: 10.2147/JMDH.S423654. eCollection 2023.
Paramedics' decision to notify receiving hospitals and transport patients to an appropriate healthcare facility is based on the Prediction of Intensive Care Unit (ICU) and Hospital Admissions guide. This study aimed to assess the paramedics' gestalt on both ward and ICU admission.
A prospective study was conducted at King Abdulaziz Medical City between September 2021 and March 2022. Paramedics were asked several questions related to the prediction of the patient's hospital outcome, including emergency department (ED) discharge or hospital admission (ICU or ward). Additional data, such as the time of the ambulance's arrival and the staff years of experience, were collected. The categorical characteristics are presented by frequency and percentage for each category.
This study included 251 paramedics and 251 patients. The average age of the patients was 62 years. Of the patients, 32 (12.7%) were trauma, and 219 (87.3%) were non-trauma patients. Two-thirds of the patients (n=171, 68.1%) were predicted to be admitted to the hospital, and 80 (31.8%) of the EMS staff indicated that the patient do not need a hospital or an ambulance. The sensitivity, specificity, PPV, and NPV of the emergency medical service (EMS) staffs' gestalt for patient admission to the hospital were, respectively (77%), (33%), (16%), and (90%). Further analysis was reported to defend the EMS staffs' gestalt based on the level of EMS staff and the nature of the emergency (medical vs trauma), are reported.
Our study reports a low level of accurately predicting patient admission to the hospital, including the ICU. The results of this study have important implications for enhancing the accuracy of EMS staff predictive ability and ensuring that patients receive appropriate care promptly.
护理人员决定通知接收医院并将患者转运至合适的医疗机构是基于重症监护病房（ICU）和医院入院预测指南。本研究旨在评估护理人员对病房和ICU入院的整体判断。
2021年9月至2022年3月在阿卜杜勒阿齐兹国王医疗城进行了一项前瞻性研究。向护理人员询问了几个与患者医院结局预测相关的问题，包括急诊科（ED）出院或医院入院（ICU或病房）。还收集了其他数据，如救护车到达时间和工作人员的工作年限。分类特征按每个类别的频率和百分比呈现。
本研究纳入了251名护理人员和251名患者。患者的平均年龄为62岁。其中，32名（12.7%）为创伤患者，219名（87.3%）为非创伤患者。三分之二的患者（n = 171，68.1%）预计会入院，80名（31.8%）的急救医疗服务（EMS）人员表示患者不需要住院或救护车。EMS人员对患者入院判断的敏感性、特异性、阳性预测值和阴性预测值分别为（77%）、（33%）、（16%）和（90%）。据报道，基于EMS人员水平和紧急情况的性质（医疗与创伤）对EMS人员的整体判断进行了进一步分析。
我们的研究报告显示，对患者包括入住ICU在内的入院情况进行准确预测的水平较低。本研究结果对于提高EMS人员预测能力的准确性以及确保患者及时获得适当护理具有重要意义。
