Department of Emergency Medicine, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, İstanbul-Türkiye.
Department of Emergency Medicine, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Aug;30(8):554-561. doi: 10.14744/tjtes.2024.90463.
This study aims to evaluate the accuracy and quality of prehospital assessments and preliminary diagnoses made by Emergency Medical Services (EMS) providers compared to the final diagnoses given by Emergency Department physicians in a metropolitan area.
This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately. Cases were categorized by EMS call time, reasons for EMS requests, age, gender, nationality, and weekday of hospital arrival to assess socioeconomic impacts and congestion patterns. The study included 2.528 pediatric cases, excluding patients aged 18 and older, those who refused EMS transfer, and cases resolved at the scene. Data analysis was conducted using IBM SPSS 27.0, with statistical significance set at p<0.05.
The study included 2.528 cases. The data revealed that EMS providers had an average of 9.9±4.7 years of experience. In 1.839 cases (72.7%), the EMS provider was female, and in 689 cases (27.3%), the EMS provider was male. Patients had an average age of 9.2±5.8 years, with 1.173 (46.4%) being female and 1.355 (53.6%) being male. Preliminary diagnosis accuracy was higher in cases involving younger and male patients. Additionally, a lower preliminary diagnosis accuracy rate was observed during office hours (08: 00-15: 59) compared to non-office hours (16: 00-23: 59). The majority of EMS calls were for medical reasons (1,783 cases, 70.5%), followed by trauma-related calls (745 cases, 29.5%).
This study highlights the need for improved on-field training for EMS providers to enhance the accuracy and quality of prehospital assessments and preliminary diagnoses. The findings suggest that younger and male patients have higher preliminary diagnosis accuracy rates, and there is a noticeable decrease in accuracy during office hours, indicating potential areas for targeted training and protocol adjustments.
本研究旨在评估大都市地区急救医疗服务（EMS）提供者进行的院前评估和初步诊断与急诊科医生给出的最终诊断的准确性和质量。
本回顾性观察研究使用了 2021 年 1 月 1 日至 2022 年 12 月 31 日安卡拉 Yenimahalle EMS 指挥中心的记录。数据记录为案例，而不是个体患者，重复的 EMS 入院分别计算。案例按 EMS 呼叫时间、EMS 请求原因、年龄、性别、国籍和入院的工作日进行分类，以评估社会经济影响和拥堵模式。该研究包括 2528 例儿科病例，不包括 18 岁及以上的患者、拒绝 EMS 转院的患者和现场解决的病例。数据分析使用 IBM SPSS 27.0 进行，统计显著性设置为 p<0.05。
该研究包括 2528 例病例。数据显示，EMS 提供者平均拥有 9.9±4.7 年的经验。在 1839 例（72.7%）中，EMS 提供者为女性，在 689 例（27.3%）中，EMS 提供者为男性。患者平均年龄为 9.2±5.8 岁，其中 1173 例（46.4%）为女性，1355 例（53.6%）为男性。在涉及年轻和男性患者的情况下，初步诊断的准确性更高。此外，与非办公时间（16:00-23:59）相比，办公时间（08:00-15:59）的初步诊断准确率较低。大多数 EMS 呼叫是医疗原因（1783 例，70.5%），其次是与创伤相关的呼叫（745 例，29.5%）。
本研究强调需要对 EMS 提供者进行现场培训，以提高院前评估和初步诊断的准确性和质量。研究结果表明，年轻和男性患者的初步诊断准确率更高，办公时间的准确性明显下降，表明需要针对这些患者进行有针对性的培训和协议调整。
