Can advanced paramedics in the field diagnose patients and predict hospital admission?

Hdl Handle:
http://hdl.handle.net/10147/301978
Title:
Can advanced paramedics in the field diagnose patients and predict hospital admission?
Authors:
Cummins, Niamh Maria; Dixon, Mark; Garavan, Carrie; Landymore, Eric; Mulligan, Noel; O'Donnell, Cathal
Affiliation:
Centre for Prehospital Research, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
Citation:
Can advanced paramedics in the field diagnose patients and predict hospital admission? 2013: Emerg Med J
Journal:
Emergency medicine journal : EMJ
Issue Date:
13-Feb-2013
URI:
http://hdl.handle.net/10147/301978
DOI:
10.1136/emermed-2012-201899
PubMed ID:
23407377
Abstract:
BACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525/748) for all cases of AP diagnosis, and is mirrored with 70% (604/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as 'treat and refer'.
Item Type:
Article
Language:
en
Keywords:
AMBULANCE SERVICE; EMERGENCY MEDICAL CARE
Local subject classification:
PARAMEDICS
ISSN:
1472-0213

Full metadata record

DC FieldValue Language
dc.contributor.authorCummins, Niamh Mariaen_GB
dc.contributor.authorDixon, Marken_GB
dc.contributor.authorGaravan, Carrieen_GB
dc.contributor.authorLandymore, Ericen_GB
dc.contributor.authorMulligan, Noelen_GB
dc.contributor.authorO'Donnell, Cathalen_GB
dc.date.accessioned2013-09-20T08:09:48Z-
dc.date.available2013-09-20T08:09:48Z-
dc.date.issued2013-02-13-
dc.identifier.citationCan advanced paramedics in the field diagnose patients and predict hospital admission? 2013: Emerg Med Jen_GB
dc.identifier.issn1472-0213-
dc.identifier.pmid23407377-
dc.identifier.doi10.1136/emermed-2012-201899-
dc.identifier.urihttp://hdl.handle.net/10147/301978-
dc.description.abstractBACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525/748) for all cases of AP diagnosis, and is mirrored with 70% (604/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as 'treat and refer'.-
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to Emergency medicine journal : EMJen_GB
dc.subjectAMBULANCE SERVICEen_GB
dc.subjectEMERGENCY MEDICAL CAREen_GB
dc.subject.otherPARAMEDICSen_GB
dc.titleCan advanced paramedics in the field diagnose patients and predict hospital admission?en_GB
dc.typeArticleen
dc.contributor.departmentCentre for Prehospital Research, Graduate Entry Medical School, University of Limerick, Limerick, Ireland.en_GB
dc.identifier.journalEmergency medicine journal : EMJen_GB

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