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dc.contributor.authorGreen, JDen
dc.contributor.authorEwings, Sen
dc.contributor.authorWortham, Ren
dc.contributor.authorWalsh, Ben
dc.date.accessioned2019-07-31T14:29:52Z
dc.date.issued2019-04-02en
dc.identifier.issn1472-0205en
dc.identifier.urihttp://hdl.handle.net/10026.1/14732
dc.description.abstract

<jats:sec><jats:title>Background</jats:title><jats:p>A new pre-triage screening tool, Nature of Call (NoC), has been introduced into the telephone triage system of UK ambulance services which employ National Health Service Pathways (NHSP). Its function is to provide rapid recognition of patients who may need immediate ambulance dispatch for out-of-hospital cardiac arrest (OHCA) and withholding dispatch for other calls while further triage is undertaken. In this study, we evaluated the accuracy of NoC and NHSP in identifying patients with potentially treatable or imminent OHCA.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This retrospective, observational study reviewed consecutive calls to a UK ambulance service between October 2016 and February 2017 in which NOC, and then NHSP were applied sequentially. Only those calls for which a corresponding electronic Patient Clinical Record was available were included. Sensitivity and specificity of NOC and NHSP for recognition of an OHCA were determined by comparing allocated priority dispositions with an OHCA Treatment Registry (OHCATR).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 96 423 calls received, 71 373 were reviewed. For 590 (0.8%) of these calls, the patients received treatment for OHCA. NOC identified 458 OHCATR patients; NHSP identified 467; together they identified 496. NoC captured 29 patients not identified by NHSP; NHSP captured 38 patients not identified by NOC. For NOC sensitivity was 77.6% (95% CI 74.1 to 80.8) and specificity 86.9% (95% CI 86.6 to 87.1). NHSP sensitivity was 79.2% (95% CI 75.7 to 82.2) and specificity 93.4% (95% CI 93.2 to 93.6). NoC and NHSP combined had a sensitivity of 84.1% (95% CI 80.9 to 86.8) and specificity of 85.3% (95% CI 85.1 to 85.6).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>NoC and NHSP call categorisation each achieved similar sensitivity for the identification of OHCATR, identifying most of the same patients, but each captured unique patients. Using both methods sequentially improved accuracy. The 16% of OHCATR patients not identified by either method present a challenge to ambulance dispatch systems.</jats:p></jats:sec>

en
dc.format.extent203 - 207en
dc.languageenen
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.titleAccuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arresten
dc.typeJournal Article
plymouth.issue4en
plymouth.volume36en
plymouth.journalEmergency Medicine Journalen
dc.identifier.doi10.1136/emermed-2017-207354en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Health Professions
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dcterms.dateAccepted2019-01-14en
dc.rights.embargodate2019-08-06en
dc.identifier.eissn1472-0213en
dc.rights.embargoperiodNot knownen
rioxxterms.versionAMen
rioxxterms.versionofrecord10.1136/emermed-2017-207354en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-04-02en
rioxxterms.typeJournal Article/Reviewen


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