Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study
Abstract Background Patients who call for emergency medical services (EMS) due to abdominal pain suffer from a broad spectrum of diseases, some of which are time sensitive. As a result of the introduction of the concept of ‘optimal level of care‘, some patients with abdominal pain are triaged to oth...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-022-00649-x |
| _version_ | 1818532647406665728 |
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| author | Glenn Larsson Peter Hansson Emelie Olsson Johan Herlitz Magnus Andersson Hagiwara |
| author_facet | Glenn Larsson Peter Hansson Emelie Olsson Johan Herlitz Magnus Andersson Hagiwara |
| author_sort | Glenn Larsson |
| collection | DOAJ |
| description | Abstract Background Patients who call for emergency medical services (EMS) due to abdominal pain suffer from a broad spectrum of diseases, some of which are time sensitive. As a result of the introduction of the concept of ‘optimal level of care‘, some patients with abdominal pain are triaged to other levels of care than in an emergency department (ED). We hypothesised that it could be challenging in a patient safety perspective. Aim This study aims to describe consecutive patients who call for EMS due to abdominal pain and are triaged to self-care by EMS clinicians. Methods This was an observational study performed in an EMS organisation in Western Sweden during 2020. The triage tool Rapid Emergency Triage and Treatment System (RETTS), which included Emergency Signs and Symptom (ESS) codes, was used to find medical records where patients with abdominal pain have been triaged to self-care and 194 patients was included in the study. Results Of total 48,311 ambulance missions, A total of 1747 patients were labelled with ESS code six (abdominal pain), including 223 (12.8%) who were given the code for self-care and 194 who were further assessed by the research group. Of these patients, 32 (16.3%) had a return visit within 96 hours due to the same symptoms and 11 (5.6%) were hospitalised. In six of these patients, the EMS triage was evaluated retrospectively and assessed as inappropriate. These patients had a final diagnosis of ruptured abdominal aneurysm (n = 1), acute appendicitis with peritonitis (n = 2) and acute pancreatitis (n = 3). All these patients required extensive evaluation and different treatments, including acute surgery, antibiotics and fluid therapy. Conclusion Amongst the 1747 patients assessed by EMS due to abdominal pain, 223 (12.8%) were triaged to self-care. Of the 194 patients who were further assessed, 16.3% required a return visit to the ED within 96 hours and 5.6% were hospitalised. Six patients had obvious time-sensitive conditions. Our study highlights the difficulties in the early assessment of abdominal pain and the requirement for an accurate decision support tool. |
| first_indexed | 2024-12-11T17:48:16Z |
| format | Article |
| id | doaj.art-72c84e6b580241b887cb1d2f588a9c6f |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-12-11T17:48:16Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-72c84e6b580241b887cb1d2f588a9c6f2022-12-22T00:56:18ZengBMCBMC Emergency Medicine1471-227X2022-06-012211910.1186/s12873-022-00649-xPrehospital assessment of patients with abdominal pain triaged to self-care at home: an observation studyGlenn Larsson0Peter Hansson1Emelie Olsson2Johan Herlitz3Magnus Andersson Hagiwara4Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsNU Hospital Group (NU), Department of Ambulance CareNU Hospital Group (NU), Department of Ambulance CareCentre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsCentre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsAbstract Background Patients who call for emergency medical services (EMS) due to abdominal pain suffer from a broad spectrum of diseases, some of which are time sensitive. As a result of the introduction of the concept of ‘optimal level of care‘, some patients with abdominal pain are triaged to other levels of care than in an emergency department (ED). We hypothesised that it could be challenging in a patient safety perspective. Aim This study aims to describe consecutive patients who call for EMS due to abdominal pain and are triaged to self-care by EMS clinicians. Methods This was an observational study performed in an EMS organisation in Western Sweden during 2020. The triage tool Rapid Emergency Triage and Treatment System (RETTS), which included Emergency Signs and Symptom (ESS) codes, was used to find medical records where patients with abdominal pain have been triaged to self-care and 194 patients was included in the study. Results Of total 48,311 ambulance missions, A total of 1747 patients were labelled with ESS code six (abdominal pain), including 223 (12.8%) who were given the code for self-care and 194 who were further assessed by the research group. Of these patients, 32 (16.3%) had a return visit within 96 hours due to the same symptoms and 11 (5.6%) were hospitalised. In six of these patients, the EMS triage was evaluated retrospectively and assessed as inappropriate. These patients had a final diagnosis of ruptured abdominal aneurysm (n = 1), acute appendicitis with peritonitis (n = 2) and acute pancreatitis (n = 3). All these patients required extensive evaluation and different treatments, including acute surgery, antibiotics and fluid therapy. Conclusion Amongst the 1747 patients assessed by EMS due to abdominal pain, 223 (12.8%) were triaged to self-care. Of the 194 patients who were further assessed, 16.3% required a return visit to the ED within 96 hours and 5.6% were hospitalised. Six patients had obvious time-sensitive conditions. Our study highlights the difficulties in the early assessment of abdominal pain and the requirement for an accurate decision support tool.https://doi.org/10.1186/s12873-022-00649-xPrehospitalEMSAssessmentTriageSelf-care |
| spellingShingle | Glenn Larsson Peter Hansson Emelie Olsson Johan Herlitz Magnus Andersson Hagiwara Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study BMC Emergency Medicine Prehospital EMS Assessment Triage Self-care |
| title | Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study |
| title_full | Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study |
| title_fullStr | Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study |
| title_full_unstemmed | Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study |
| title_short | Prehospital assessment of patients with abdominal pain triaged to self-care at home: an observation study |
| title_sort | prehospital assessment of patients with abdominal pain triaged to self care at home an observation study |
| topic | Prehospital EMS Assessment Triage Self-care |
| url | https://doi.org/10.1186/s12873-022-00649-x |
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