| dc.contributor.author | Almeida, G | |
| dc.contributor.author | Gusmão, M | |
| dc.contributor.author | Santos, C | |
| dc.contributor.author | Carvalho, T | |
| dc.contributor.author | Amaral, T | |
| dc.date.accessioned | 2017-06-06T15:25:59Z | |
| dc.date.available | 2017-06-06T15:25:59Z | |
| dc.date.issued | 2017-05 | |
| dc.description.abstract | Introduction: Pre-hospital emergency cases include the patient’s transportation to the hospital, with an adequate escort, when indicated. In Portugal, secondary transport’s escort is guided by an escort score published by the Portuguese Medical Association’s Guidelines on the Critical Care Patient’s Transport (2008). This score (TS) defines three levels of escort: no medical escort (level A), doctor or nurse escort (level B), doctor and nurse escort (level C). There is no published data on this score’s application to the pre-hospital setting. Such use could improve resource management in the pre-hospital emergency medical services, as it could support the need to involve a doctor and/or nurse in the patient’s escort to the hospital. Our study’s aim is the evaluate the TS application to the pre-hospital context. Study Methods: We gathered data from primary transports’ escorts between January 2015 and January 2017. We recorded whether the patient was taken to hospital or not, and if yes, the transport’s escort (Doctor, Doctor and Nurse, or only emergency technicians). Posteriorly, we calculated the TS for each of those transport records. Any records with incomplete escort data or where the score could not be calculated were excluded. Using this data, we calculated Sensibility (Ss), Specificity (Sp), positive predicitive value (PPV) and negative predictive value (NPV) of the TS for the following situations: Escort by emergency technicians only (level A), escort by doctor or nurse (level B) or escort by doctor and nurse (level C) Results and discussion: We found complete data regarding 556 primary transports 141 patients were escorted by emergency technicians only, 269 by doctor or nurse only, and 146 by a doctor and nurse. TS level A was found to have Ss 85,78%, Sp 70,92%, PPV 89,67% and NPV 62,89% regarding escort by emergency technicians only. These values support the decision of taking no medical escort in a primary transport in the pre-hospital setting when TS is level A. On the other hand, TS level C has Ss 78,08%, Sp 59,72%, PPV 40,57% and NPV 88,36% regarding escort by both a doctor and nurse. These numbers are less clear regarding a decision to take a medical escort. Conclusions: TS appears to be an indicator with enough Ss and Sp to help the pre-hospital team choose whether or not to escort the patient to the hospital with only emergency technicians or with a more differentiated escort, especially when the score’s result is Level A. But it cannot differentiate between doctor or nurse or both doctor and nurse when the result is level B or C. More figures are needed to understand if this score can be implemented as a decision tool regarding the kind of medical escort a patient needs in a primary transport. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | IN: 2nd European Emergency Medical Services Congress; 2017, 22 a 24 May. Copenhagen, Denmark | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/2693 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.subject | HSJ URG | pt_PT |
| dc.subject | HSJ ANS | pt_PT |
| dc.subject | Patient Escort Service | pt_PT |
| dc.subject | Critical Care | pt_PT |
| dc.title | Medical Escort of Critical Care Patients in the Pre-Hospital Setting | pt_PT |
| dc.type | other | |
| dspace.entity.type | Publication | |
| oaire.citation.conferencePlace | Tivoli Hotel & Congress Center | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | other | pt_PT |
