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dc.contributor.authorGreen, Jonathan
dc.contributor.authorEwings, S
dc.contributor.authorWortham, R
dc.contributor.authorWalsh, B
dc.date.accessioned2019-07-31T14:29:52Z
dc.date.issued2019-04-02
dc.identifier.issn1472-0205
dc.identifier.issn1472-0213
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>

dc.format.extent203-207
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherBMJ Publishing Group
dc.subjectcardiac arrest
dc.subjectchain of survival and prehospital care
dc.subjectdespatch
dc.subjectemergency ambulance systems
dc.subjecttriage
dc.subjectAmbulances
dc.subjectElectronic Health Records
dc.subjectEmergency Medical Service Communication Systems
dc.subjectEmergency Medical Services
dc.subjectEngland
dc.subjectHumans
dc.subjectOut-of-Hospital Cardiac Arrest
dc.subjectRegistries
dc.subjectRetrospective Studies
dc.subjectSensitivity and Specificity
dc.subjectTelephone
dc.subjectTriage
dc.titleAccuracy of nature of call screening tool in identifying patients requiring treatment for out of hospital cardiac arrest
dc.typejournal-article
dc.typeJournal Article
dc.typeObservational Study
plymouth.author-urlhttps://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000471816800004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008
plymouth.issue4
plymouth.volume36
plymouth.publication-statusPublished
plymouth.journalEmergency Medicine Journal
dc.identifier.doi10.1136/emermed-2017-207354
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/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2019-01-14
dc.rights.embargodate2019-8-6
dc.identifier.eissn1472-0213
dc.rights.embargoperiodNot known
rioxxterms.versionAccepted Manuscript
rioxxterms.versionofrecord10.1136/emermed-2017-207354
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2019-04-02
rioxxterms.typeJournal Article/Review


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