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Abstract：
BACKGROUND: This study aims to evaluate the accuracy and quality of prehospital assessments and preliminary diagnoses made by Emergency Medical Services (EMS) providers compared to the final diagnoses given by Emergency Department physicians in a metropolitan area.
METHODS: This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately. Cases were categorized by EMS call time, reasons for EMS requests, age, gender, nationality, and weekday of hospital arrival to assess socioeconomic impacts and congestion patterns. The study included 2.528 pediatric cases, excluding patients aged 18 and older, those who refused EMS transfer, and cases resolved at the scene. Data analysis was conducted using IBM SPSS 27.0, with statistical significance set at p<0.05.
RESULTS: The study included 2.528 cases. The data revealed that EMS providers had an average of 9.9±4.7 years of experience. In 1.839 cases (72.7%), the EMS provider was female, and in 689 cases (27.3%), the EMS provider was male. Patients had an average age of 9.2±5.8 years, with 1.173 (46.4%) being female and 1.355 (53.6%) being male. Preliminary diagnosis accuracy was higher in cases involving younger and male patients. Additionally, a lower preliminary diagnosis accuracy rate was observed during office hours (08: 00-15: 59) compared to non-office hours (16: 00-23: 59). The majority of EMS calls were for medical reasons (1,783 cases, 70.5%), followed by trauma-related calls (745 cases, 29.5%).
CONCLUSIONS: This study highlights the need for improved on-field training for EMS providers to enhance the accuracy and quality of prehospital assessments and preliminary diagnoses. The findings suggest that younger and male patients have higher preliminary diagnosis accuracy rates, and there is a noticeable decrease in accuracy during office hours, indicating potential areas for targeted training and protocol adjustments.
METHODS: This retrospective observational study utilized records from the Yenimahalle EMS Command Center in Ankara, Türkiye, from January 1, 2021, to December 31, 2022. Data were recorded as cases rather than individual patients, with repeated EMS admissions counted separately. Cases were categorized by EMS call time, reasons for EMS requests, age, gender, nationality, and weekday of hospital arrival to assess socioeconomic impacts and congestion patterns. The study included 2.528 pediatric cases, excluding patients aged 18 and older, those who refused EMS transfer, and cases resolved at the scene. Data analysis was conducted using IBM SPSS 27.0, with statistical significance set at p<0.05.
RESULTS: The study included 2.528 cases. The data revealed that EMS providers had an average of 9.9±4.7 years of experience. In 1.839 cases (72.7%), the EMS provider was female, and in 689 cases (27.3%), the EMS provider was male. Patients had an average age of 9.2±5.8 years, with 1.173 (46.4%) being female and 1.355 (53.6%) being male. Preliminary diagnosis accuracy was higher in cases involving younger and male patients. Additionally, a lower preliminary diagnosis accuracy rate was observed during office hours (08: 00-15: 59) compared to non-office hours (16: 00-23: 59). The majority of EMS calls were for medical reasons (1,783 cases, 70.5%), followed by trauma-related calls (745 cases, 29.5%).
CONCLUSIONS: This study highlights the need for improved on-field training for EMS providers to enhance the accuracy and quality of prehospital assessments and preliminary diagnoses. The findings suggest that younger and male patients have higher preliminary diagnosis accuracy rates, and there is a noticeable decrease in accuracy during office hours, indicating potential areas for targeted training and protocol adjustments.
摘要：
背景：本研究旨在评估由急诊医疗服务（EMS）提供者进行的院前评估和初步诊断的准确性和质量，与大都市地区急诊科医生进行的最终诊断相比。
方法：这项回顾性观察研究利用了安卡拉YenimahalleEMS指挥中心的记录，蒂尔基耶,从2021年1月1日至2022年12月31日。数据记录为病例而不是单个患者，重复的EMS入院单独计算。案件按EMS呼叫时间分类，EMS请求的原因，年龄,性别,国籍,以及医院到达的工作日，以评估社会经济影响和拥堵模式。该研究包括2.528例儿科病例，不包括18岁及以上的病人，那些拒绝EMS转移的人，案件在现场解决。使用IBMSPSS27.0进行数据分析,统计学显著性设定为p<0.05。
结果：本研究包括2.528例。数据显示，EMS提供商的平均经验为9.9±4.7年。在1.839例（72.7%）中，EMS供应商是女性，689例(27.3%)，EMS提供者是男性。患者平均年龄为9.2±5.8岁，女性为1.173（46.4％），男性为1.355（53.6％）。在涉及年轻和男性患者的病例中，初步诊断准确性更高。此外,与非办公时间(16:00-23:59)相比,办公时间(08:00-15:59)的初步诊断准确率较低.大多数紧急呼叫是出于医疗原因(1783例，70.5%），其次是与创伤相关的电话(745例，29.5%）。
结论：本研究强调需要改进EMS提供者的现场培训，以提高院前评估和初步诊断的准确性和质量。研究结果表明，年轻和男性患者的初步诊断准确率更高，并且在办公时间内的准确性显着下降，指出有针对性的培训和方案调整的潜在领域。
方法：这项回顾性观察研究利用了安卡拉YenimahalleEMS指挥中心的记录，蒂尔基耶,从2021年1月1日至2022年12月31日。数据记录为病例而不是单个患者，重复的EMS入院单独计算。案件按EMS呼叫时间分类，EMS请求的原因，年龄,性别,国籍,以及医院到达的工作日，以评估社会经济影响和拥堵模式。该研究包括2.528例儿科病例，不包括18岁及以上的病人，那些拒绝EMS转移的人，案件在现场解决。使用IBMSPSS27.0进行数据分析,统计学显著性设定为p<0.05。
结果：本研究包括2.528例。数据显示，EMS提供商的平均经验为9.9±4.7年。在1.839例（72.7%）中，EMS供应商是女性，689例(27.3%)，EMS提供者是男性。患者平均年龄为9.2±5.8岁，女性为1.173（46.4％），男性为1.355（53.6％）。在涉及年轻和男性患者的病例中，初步诊断准确性更高。此外,与非办公时间(16:00-23:59)相比,办公时间(08:00-15:59)的初步诊断准确率较低.大多数紧急呼叫是出于医疗原因(1783例，70.5%），其次是与创伤相关的电话(745例，29.5%）。
结论：本研究强调需要改进EMS提供者的现场培训，以提高院前评估和初步诊断的准确性和质量。研究结果表明，年轻和男性患者的初步诊断准确率更高，并且在办公时间内的准确性显着下降，指出有针对性的培训和方案调整的潜在领域。
