New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients

Background: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients’ conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients...

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Main Authors: Federico Semeraro, Giovanni Corona, Tommaso Scquizzato, Lorenzo Gamberini, Anna Valentini, Marco Tartaglione, Andrea Scapigliati, Giuseppe Ristagno, Carmela Martella, Carlo Descovich, Cosimo Picoco, Giovanni Gordini
Format: Article
Language:English
Published: MDPI AG 2021-06-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/10/12/2617
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author Federico Semeraro
Giovanni Corona
Tommaso Scquizzato
Lorenzo Gamberini
Anna Valentini
Marco Tartaglione
Andrea Scapigliati
Giuseppe Ristagno
Carmela Martella
Carlo Descovich
Cosimo Picoco
Giovanni Gordini
author_facet Federico Semeraro
Giovanni Corona
Tommaso Scquizzato
Lorenzo Gamberini
Anna Valentini
Marco Tartaglione
Andrea Scapigliati
Giuseppe Ristagno
Carmela Martella
Carlo Descovich
Cosimo Picoco
Giovanni Gordini
author_sort Federico Semeraro
collection DOAJ
description Background: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients’ conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients and to trigger appropriate care in the pre-hospital setting. Methods: A single centre, longitudinal, prospective study was carried out between July and August 2020 in the EMS service of Bologna. Home patients with age ≥ 18 years old were included in the study. The exclusion criterion was the impossibility to collect all the parameters needed to measure NEWS. Results: A total of 654 patients were enrolled in the study. The recorded NEWS values increased along with the severity of dispatch priority code, the EMS return code, the emergency department triage code, and with patients’ age (r = 0.135; <i>p</i> = 0.001). The aggregated value of NEWS was associated with an increased risk of hospitalization (OR = 1.30 (1.17; 1.34); <i>p</i> < 0.0001). Conclusion: This study showed that the use of NEWS in the urgent and emergency care services can help patient assessment while not affecting EMS crew operation and might assist decision making in terms of severity-code assignment and resources utilization.
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spelling doaj.art-10eeb9c2dfcf48f286227e166d49a3d62023-11-22T00:04:30ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-011012261710.3390/jcm10122617New Early Warning Score: EMS Off-Label Use in Out-of-Hospital PatientsFederico Semeraro0Giovanni Corona1Tommaso Scquizzato2Lorenzo Gamberini3Anna Valentini4Marco Tartaglione5Andrea Scapigliati6Giuseppe Ristagno7Carmela Martella8Carlo Descovich9Cosimo Picoco10Giovanni Gordini11Department of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, ItalyEndocrinology Unit, Maggiore-Bellaria Hospital, 3-40139 Bologna, ItalyDepartment of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, ItalyDepartment of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, ItalyDepartment of Medical and Surgical Sciences, Alma Mater Studiorum University, 40126 Bologna, ItalyDepartment of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, ItalyInstitute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, 00168 Milan, ItalyDepartment of Medical and Surgical Sciences, Alma Mater Studiorum University, 40126 Bologna, ItalyClinical Governance and Quality Unit, Bologna Local Healthcare Authority Staff, 40133 Bologna, ItalyDepartment of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, ItalyDepartment of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, ItalyBackground: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients’ conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients and to trigger appropriate care in the pre-hospital setting. Methods: A single centre, longitudinal, prospective study was carried out between July and August 2020 in the EMS service of Bologna. Home patients with age ≥ 18 years old were included in the study. The exclusion criterion was the impossibility to collect all the parameters needed to measure NEWS. Results: A total of 654 patients were enrolled in the study. The recorded NEWS values increased along with the severity of dispatch priority code, the EMS return code, the emergency department triage code, and with patients’ age (r = 0.135; <i>p</i> = 0.001). The aggregated value of NEWS was associated with an increased risk of hospitalization (OR = 1.30 (1.17; 1.34); <i>p</i> < 0.0001). Conclusion: This study showed that the use of NEWS in the urgent and emergency care services can help patient assessment while not affecting EMS crew operation and might assist decision making in terms of severity-code assignment and resources utilization.https://www.mdpi.com/2077-0383/10/12/2617cardiac arrestEMSNational Early Warning ScoreNEWSambulanceapps
spellingShingle Federico Semeraro
Giovanni Corona
Tommaso Scquizzato
Lorenzo Gamberini
Anna Valentini
Marco Tartaglione
Andrea Scapigliati
Giuseppe Ristagno
Carmela Martella
Carlo Descovich
Cosimo Picoco
Giovanni Gordini
New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
Journal of Clinical Medicine
cardiac arrest
EMS
National Early Warning Score
NEWS
ambulance
apps
title New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
title_full New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
title_fullStr New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
title_full_unstemmed New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
title_short New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients
title_sort new early warning score ems off label use in out of hospital patients
topic cardiac arrest
EMS
National Early Warning Score
NEWS
ambulance
apps
url https://www.mdpi.com/2077-0383/10/12/2617
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