Manten Amy, van den Bulk Simone, Rutten Frans H, Willemsen Robert T A, Bonten Tobias N, Harskamp Ralf E
Amsterdam UMC, locatie AMC, afd. Huisartsgeneeskunde, Amsterdam Cardiovascular Sciences Research Institute, Amsterdam.
LUMC, afd. Public Health en Huisartsgeneeskunde, Leiden.
Ned Tijdschr Geneeskd. 2023 Aug 8;167:D7379.
Out-of-hours primary care (OOH-PC) facilities act as a first point of contact in acute care in the Netherlands, including acute chest pain. The facilities perform initial triage to assess the patient's urgency using standardized triage protocols (Netherlands Triage Standard). The performance of the current protocol for chest pain assessment was recently evaluated and showed only moderate discriminatory properties. Although final triage decision-making is improved by the clinical experience of triage assistants and general practitioners, substantial over- and under-triage persists. Improving the care of patients with chest pain in OOH-PC should primarily be sought in improving the triage software, followed by the use of innovative diagnostic tools (such as troponine measurements).
非工作时间的初级医疗保健（OOH-PC）设施在荷兰急性护理中作为第一接触点，包括急性胸痛。这些设施使用标准化分诊协议（荷兰分诊标准）进行初始分诊以评估患者的紧急程度。最近对当前胸痛评估协议的性能进行了评估，结果显示其鉴别特性仅为中等。尽管分诊助理和全科医生的临床经验改善了最终分诊决策，但过度分诊和分诊不足的情况仍然严重。改善OOH-PC中胸痛患者的护理应主要寻求改进分诊软件，其次是使用创新诊断工具（如肌钙蛋白测量）。
