Prehospital triage of patients with acute cardiac complaints: study protocol of HART-c, a multicentre prospective study
| Autor: | Jan Bosch, Mark J. Boogers, Saskia L.M.A. Beeres, Tom E Biersteker, Reza Alizadeh Dehnavi, Charles J. H. J. Kirchhof, Enrico de Koning, Barbra E Backus, Helen Am Silvius, Martin J. Schalij |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Emergency Medical Services
Vital signs Cardiology 030204 cardiovascular system & hematology Cardiovascular Medicine Chest pain organisation of health services 03 medical and health sciences Electrocardiography 0302 clinical medicine medicine Emergency medical services accident & emergency medicine Humans Multicenter Studies as Topic Medical history 030212 general & internal medicine Prospective Studies business.industry Medical record General Medicine Overcrowding Emergency department medicine.disease Triage myocardial infarction Medical emergency telemedicine medicine.symptom business Emergency Service Hospital accident &emergency medicine |
| Zdroj: | BMJ Open BMJ Open, 11(2). BMJ PUBLISHING GROUP |
| ISSN: | 2044-6055 |
| Popis: | IntroductionEmergency department (ED) overcrowding is a major healthcare problem associated with worse patient outcomes and increased costs. Attempts to reduce ED overcrowding of patients with cardiac complaints have so far focused on in-hospital triage and rapid risk stratification of patients with chest pain at the ED. The Hollands-Midden Acute Regional Triage—Cardiology (HART-c) study aimed to assess the amount of patients left at home in usual ambulance care as compared with the new prehospital triage method. This method combines paramedic assessment and expert cardiologist consultation using live monitoring, hospital data and real-time admission capacity.Methods and analysisPatients visited by the emergency medical services (EMS) for cardiac complaints are included. EMS consultation consists of medical history, physical examination and vital signs, and ECG measurements. All data are transferred to a newly developed platform for the triage cardiologist. Prehospital data, in-hospital medical records and real-time admission capacity are evaluated. Then a shared decision is made whether admission is necessary and, if so, which hospital is most appropriate. To evaluate safety, all patients left at home and their general practitioners (GPs) are contacted for 30-day adverse events.Ethics and disseminationThe study is approved by the LUMC’s Medical Ethics Committee. Patients are asked for consent for contacting their GPs. The main results of this trial will be disseminated in one paper.DiscussionThe HART-c study evaluates the efficacy and feasibility of a prehospital triage method that combines prehospital patient assessment and direct consultation of a cardiologist who has access to live-monitored data, hospital data and real-time hospital admission capacity. We expect this triage method to substantially reduce unnecessary ED visits. |
| Databáze: | OpenAIRE |
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