Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland
Abstract Background Increasing numbers of dispatches place a burden on EMS; this study sought to assess the prehospital evaluation of poisoned patients transported to hospital. The primary aim of this study was to measure dispatch centre and EMS provider performance as well as factors contributing t...
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crwiley:10.1111/aas.14152 2024-06-02T08:12:00+00:00 Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland Koskela, Lauri Raatiniemi, Lasse Ehrola, Ari Kaakinen, Timo Lahtinen, Sanna Liisanantti, Janne Suomen Lääketieteen Säätiö 2022 http://dx.doi.org/10.1111/aas.14152 https://onlinelibrary.wiley.com/doi/pdf/10.1111/aas.14152 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/aas.14152 en eng Wiley http://creativecommons.org/licenses/by/4.0/ Acta Anaesthesiologica Scandinavica volume 67, issue 1, page 112-119 ISSN 0001-5172 1399-6576 journal-article 2022 crwiley https://doi.org/10.1111/aas.14152 2024-05-03T10:59:59Z Abstract Background Increasing numbers of dispatches place a burden on EMS; this study sought to assess the prehospital evaluation of poisoned patients transported to hospital. The primary aim of this study was to measure dispatch centre and EMS provider performance as well as factors contributing to the recognition of poisoning among prehospital patients. The secondary aim was to compare triage performance between dispatch centres and EMS providers. Methods A retrospective single‐centre study in Northern Finland was conducted. Patients suspected as poisonings by dispatch centres as well as other EMS‐transported patients who received a diagnosis of poisoning in hospital between June 1, 2015 and June 1, 2017, were included. Results There were a total of 1668 poisoning‐related EMS missions. Dispatch centres suspected poisonings with sensitivity of 79.9% (95% CI 76.7–82.9) and specificity of 98.9% (95% CI 98.9–99.0) when all EMS missions were taken into account. In a logistic regression model, decreased state of consciousness as dispatch code (OR 7.18, 95% CI 1.90–27.05) and intravenous fluid resuscitation (OR 6.58, 95% CI 1.34–32.37) were associated with EMS transport providers not recognizing poisoning. Overtriage rate appeared significantly higher (33.6%, 95% CI 28.6–39.2) for dispatch when compared with transport (17.8%, 95% CI 13.9–22.6). Conclusion Dispatch centres seem to suspect poisonings fairly accurately. Poisonings unrecognized by EMS providers may be linked with intravenous fluid resuscitation and decreased patient consciousness. Overtriage appears to resolve somewhat from dispatch to transport. There were no fatal poisonings in this study population. Article in Journal/Newspaper Northern Finland Wiley Online Library Acta Anaesthesiologica Scandinavica 67 1 112 119 |
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Abstract Background Increasing numbers of dispatches place a burden on EMS; this study sought to assess the prehospital evaluation of poisoned patients transported to hospital. The primary aim of this study was to measure dispatch centre and EMS provider performance as well as factors contributing to the recognition of poisoning among prehospital patients. The secondary aim was to compare triage performance between dispatch centres and EMS providers. Methods A retrospective single‐centre study in Northern Finland was conducted. Patients suspected as poisonings by dispatch centres as well as other EMS‐transported patients who received a diagnosis of poisoning in hospital between June 1, 2015 and June 1, 2017, were included. Results There were a total of 1668 poisoning‐related EMS missions. Dispatch centres suspected poisonings with sensitivity of 79.9% (95% CI 76.7–82.9) and specificity of 98.9% (95% CI 98.9–99.0) when all EMS missions were taken into account. In a logistic regression model, decreased state of consciousness as dispatch code (OR 7.18, 95% CI 1.90–27.05) and intravenous fluid resuscitation (OR 6.58, 95% CI 1.34–32.37) were associated with EMS transport providers not recognizing poisoning. Overtriage rate appeared significantly higher (33.6%, 95% CI 28.6–39.2) for dispatch when compared with transport (17.8%, 95% CI 13.9–22.6). Conclusion Dispatch centres seem to suspect poisonings fairly accurately. Poisonings unrecognized by EMS providers may be linked with intravenous fluid resuscitation and decreased patient consciousness. Overtriage appears to resolve somewhat from dispatch to transport. There were no fatal poisonings in this study population. |
author2 |
Suomen Lääketieteen Säätiö |
format |
Article in Journal/Newspaper |
author |
Koskela, Lauri Raatiniemi, Lasse Ehrola, Ari Kaakinen, Timo Lahtinen, Sanna Liisanantti, Janne |
spellingShingle |
Koskela, Lauri Raatiniemi, Lasse Ehrola, Ari Kaakinen, Timo Lahtinen, Sanna Liisanantti, Janne Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
author_facet |
Koskela, Lauri Raatiniemi, Lasse Ehrola, Ari Kaakinen, Timo Lahtinen, Sanna Liisanantti, Janne |
author_sort |
Koskela, Lauri |
title |
Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
title_short |
Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
title_full |
Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
title_fullStr |
Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
title_full_unstemmed |
Accuracy of dispatch and prehospital triage performance in poisonings – A retrospective study from northern Finland |
title_sort |
accuracy of dispatch and prehospital triage performance in poisonings – a retrospective study from northern finland |
publisher |
Wiley |
publishDate |
2022 |
url |
http://dx.doi.org/10.1111/aas.14152 https://onlinelibrary.wiley.com/doi/pdf/10.1111/aas.14152 https://onlinelibrary.wiley.com/doi/full-xml/10.1111/aas.14152 |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
Acta Anaesthesiologica Scandinavica volume 67, issue 1, page 112-119 ISSN 0001-5172 1399-6576 |
op_rights |
http://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1111/aas.14152 |
container_title |
Acta Anaesthesiologica Scandinavica |
container_volume |
67 |
container_issue |
1 |
container_start_page |
112 |
op_container_end_page |
119 |
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1800758315185078272 |