Characteristics of the prehospital phase of adult emergency department patients with an infection

Autor: Lieke Claassen, Patricia M. Stassen, Gideon H. P. Latten, Jean W M Muris, Marnix Jonk, Jochen W L Cals
Přispěvatelé: Family Medicine, RS: CAPHRI - R5 - Optimising Patient Care, Family Medicine Education, Interne Geneeskunde, MUMC+: MA Alg Interne Geneeskunde (9)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Critical Care and Emergency Medicine
Pulmonology
Physiology
Ambulances
Transportation
Pilot Projects
Disease
Pathology and Laboratory Medicine
DEFINITIONS
0302 clinical medicine
Antibiotics
Medicine and Health Sciences
Emergency medical services
Medicine
EPIDEMIOLOGY
Hospital Mortality
Prospective Studies
030212 general & internal medicine
Multidisciplinary
Antimicrobials
Respiration
Drugs
Middle Aged
Hospitalization
Engineering and Technology
Female
Emergency Service
Hospital
Research Article
Adult
medicine.medical_specialty
Adverse outcomes
Science
Primary care
Microbiology
Sepsis
03 medical and health sciences
Signs and Symptoms
Diagnostic Medicine
Microbial Control
Intensive care
Humans
Aged
Quality of Health Care
Pharmacology
SEPSIS
business.industry
MORTALITY
SEPTIC SHOCK
Biology and Life Sciences
030208 emergency & critical care medicine
Emergency department
medicine.disease
Triage
Severe Sepsis
Respiratory Infections
Emergency medicine
Physiological Processes
business
Zdroj: PLOS ONE, 14(2):0212181. Public Library of Science
PLoS ONE, Vol 14, Iss 2, p e0212181 (2019)
PLoS ONE
ISSN: 1932-6203
Popis: ObjectiveResearch on serious infections/sepsis has focused on the hospital environment, while potentially the most delay, and therefore possibly the best opportunity to improve quality of care, lies in the prehospital setting. In this study we investigated the prehospital phase of adult emergency department (ED) patients with an infection.MethodsIn this prospective pilot study all adult (>= 18y) patients with a suspected/proven infection, based on the notes in the patient's ED chart, were included during a 4-week period in 2017. Prehospital course, ED findings, presence of sepsis and 30-day outcomes were registered.ResultsA total of 440 patients were identified, with a median symptom duration before ED visit of 3 days (IQR 1-7 days). Before arrival in the ED, 23.9% of patients had used antibiotics. Most patients (83.0%) had been referred by a general practitioner (GP), while 41.1% of patients had visited their GP previously during the current disease episode. Patients referred by a GP were triaged as high-urgency less often, while vital parameters were similar. Emergency Medical Services (EMS) transported 268 (60.9%) of patients. Twenty-two patients (5.0%) experienced an adverse outcome (30-day all-cause mortality and/or admission to intensive care).ConclusionsPatients with a suspected infection had symptoms for 3 (IQR 1-7) days at the moment of presentation to the ED. During this prehospital phase patients often had consulted, and were treated by, their GP. Many were transported to the ED by EMS. Future research on severe infections should focus on the prehospital phase, targeting patients and primary care professionals.
Databáze: OpenAIRE
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