Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report
نویسندگان
چکیده
INTRODUCTION Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC). METHOD In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards. RESULTS 101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor. CONCLUSION There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.
منابع مشابه
The Effect of Implementation of a Pain Monitoring Protocol on the Pain Intensity in the Intensive Care Unit Semiconscious Patients
Background: Neglecting the pain assessment in intensive care unit (ICU) patients with decreased level of consciousness (LOC) can lead to inappropriate pain management. Implementation of a pain management protocol may contribute to avoiding such negligence. Aim: This study aimed to determine the effect of using a pain monitoring protocol on the pain intensity of ICU patients with decreased LOC. ...
متن کاملDetermining the Telephony Triage Outcome in Patients with Chest Pain in Emergency Center in 115 provinces of Qom according to the New Jersey Modified Protocol in the first half of 1396
Introduction: The most common complaint of heart patients is pain and chest discomfort. The delay in transmitting patients from the onset of symptoms to reaching a treatment center is one of the most important reasons for the deaths of these patients. There is a direct relationship between the early services provided by the pre-hospital emergency room with positive therapeutic outcomes and the ...
متن کاملAssessment of Pain Management In Pediatric ED In Mashhad
Introduction: Pain may be described as a feeling of hurt or strong discomfort and is the body's way of sending a message to the brain that an injury has occurred. Pain medicine blocks these messages or reduces their effect on the brain. Timely administration of analgesia affects the entire emergency medical experience and can have a lasting effect on a child’s and family’s reaction to current a...
متن کاملComparison between GRACE and TIMI scores in predicting significant cardiovascular events in patients with chest pain: brief report
Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients. Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmi...
متن کاملAssessment of Pain Management in Pediatric Emergency Department in Mashhad -Iran
Introduction: Pain may be described as a sensation of hurt or strong discomfort and is the body's way of sending message to the brain that an injury has occurred. Pain medicines block these messages or reduce their effect on the brain. Accurate administration of analgesia have a long –lasting effect on children whole experience of medical care and affects parents' and children's future reaction...
متن کامل