American College of Emergency Physicians Research. Forum. San Diego USA, 1994/03.
To compare rates of undertriage and overtriage of six ambulance dispatch protocols for the presenting complaint of nontraumatic abdominal pain, and to identify the optimal protocol.
Retrospective prehospital and emergency department chart review to classify patients'conditions as « emergency » or « nonemergency. » Results : Six ambulance dispatch protocols for nontraumatic abdominal pain were developed : indiscriminate-dispatch, four selective protocols, and no-dispatch.
A dichotomous classification system was derived prospectively from the prehospital and medical records of patients who had activated the EMS system before the study period to define « emergency » and « nonemergency » conditions associated with nontraumatic abdominal pain.
Emergency criteria identified patients with conditions requiring medical treatment within 1 hour.
Reviewers determined, for each patient, whether an ambulance would have been dispatched by each of the protocols.
Undertriage and overtriage rates were calculated for each protocol.
County EMS medical directors assigned utility values to four potential outcomes of ambulance dispatch by the direct scaling method.
The outcomes comprised correct and incorrect decisions to dispatch ambulances to patients with and without emergencies.
The majority of patients with nontraumatic abdominal pain who requested ambulance transport during the study period did not have conditions that were classified as emergencies.
Mots-clés Pascal : Douleur, Abdomen, Triage, Urgence, Transport sanitaire, Analyse coût efficacité, Homme, Etude comparative, Abdomen pathologie, Soin intensif
Mots-clés Pascal anglais : Pain, Abdomen, Sorting, Emergency, Medical transport, Cost efficiency analysis, Human, Comparative study, Abdominal disease, Intensive care
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Cote : 96-0004786
Code Inist : 002B27B14C. Création : 01/03/1996.