Bell S, Hill J E
North West Ambulance Service NHS Trust.
University of Central Lancashire.
J Paramed Pract. 2023 Dec 2;15(12):516-519. doi: 10.12968/jpar.2023.15.12.516.
The utilisation of pre-hospital early warning scores in ambulance services is widely endorsed to promptly identify patients at risk of clinical deterioration. Early warning scores enable clinicians to estimate risk based on clinical observations and vital signs, with higher scores indicating an elevated risk of adverse outcomes. Local healthcare systems establish threshold values for these scores to guide clinical decision-making, triage, and response, necessitating a careful balance between identifying critically unwell patients and managing the challenge of prioritisation. Given the limited evidence for optimal early warning scores in emergency department and pre-hospital care settings, a systematic review by Guan et al. (2022) was undertaken to assess the diagnostic accuracy of early warning scores for predicting in-hospital deterioration when applied in the emergency department or pre-hospital setting. This commentary aims to critically appraise the methods used within the review Guan et al (2022) and expand upon the findings in the context of clinical practice.
在救护服务中使用院前早期预警评分得到了广泛认可，以便迅速识别有临床病情恶化风险的患者。早期预警评分使临床医生能够根据临床观察和生命体征来评估风险，分数越高表明不良后果风险越高。当地医疗系统会为这些评分设定阈值，以指导临床决策、分诊和应对措施，这就需要在识别病情危急的患者与应对优先级挑战之间谨慎权衡。鉴于急诊和院前护理环境中关于最佳早期预警评分的证据有限，关等人（2022年）进行了一项系统综述，以评估早期预警评分在急诊科或院前环境中应用时预测院内病情恶化的诊断准确性。本评论旨在严格评估关等人（2022年）综述中使用的方法，并在临床实践背景下对研究结果进行拓展。
