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Prehospital caregiver's adherence to treatment guidelines for patients with non-traumatic acute chest pain

Byrsell, Fredrik and Regnell, Mattias (2011)
Department of Health Sciences
Abstract
Studies has shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is inadequate and that there is a treatment difference between genders. The aim of this study was to examine prehospital caregiver¡¯s adherence to treatment guidelines for patients with non-traumatic chest pain and compare treatment frequencies between men and women in a region in southern Sweden. Methods: A retrospective cohort study, including 862 medical records, where the prehospital caregiver¡¯s primary assessment was non-traumatic acute chest pain, was reviewed. The time period examined was from January first until last December 2009. Data of gender, age, time of day, frequencies of intravenous lines and specific... (More)
Studies has shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is inadequate and that there is a treatment difference between genders. The aim of this study was to examine prehospital caregiver¡¯s adherence to treatment guidelines for patients with non-traumatic chest pain and compare treatment frequencies between men and women in a region in southern Sweden. Methods: A retrospective cohort study, including 862 medical records, where the prehospital caregiver¡¯s primary assessment was non-traumatic acute chest pain, was reviewed. The time period examined was from January first until last December 2009. Data of gender, age, time of day, frequencies of intravenous lines and specific treatment guidelines including; oxygen, acetylsalicylic acid, sublingual trinitrate glycerin, twelve lead electrocardiograms, pain assessment, and intravenous analgesia was obtained. Results were presented using descriptive statistics according to numbers of patients, mean, median, standard deviation and quartiles when appropriate. Adherence to present guidelines were described into following values; < or equal to 20% = Poor, 21 ¨C 40% = Fair, 41 ¨C 60% = Moderate, 61 ¨C 80% = Good and 81 ¨C 100% = Very good.Results: Of the 862 included medical records, 401 were women and 461 were men. Women¡¯s mean age was 71¡À16 versus men¡¯s 69¡À14, respectively (p<0.05). Twenty-three percent of the patient¡¯s received ¡Ý10 liters of oxygen (men versus women, ns). Sixty-nine percent received treatment with sublingual glyceryl trinitrate, whereas 58% percent of the patients received acetylsalicylic acid (men versus women, p<0.05). Ninety five percent of the patients had a twelve lead electrocardiogram obtained and 40% had their pain assessed with pain scales before treatment with analgesia (men versus women, p<0.05) and 37% after treatment (men versus women, ns). Sixty-seven percent received an intravenous line (men versus women, p<0.05) whereas 10% received Morphine sulphate and 1% received ¦Â-blocker, respectively (men versus women, ns). A significant difference were found in time of day for prehospital emergency care (p<0.05).Conclusions: We conclude that adherence to treatment guidelines vary between the different variables studied, ranging from fair (¡Ý10L Oxygen) to very good (obtaining electrocardiogram). We also conclude differences in treatment between women and men. (Less)
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author
Byrsell, Fredrik and Regnell, Mattias
supervisor
organization
alternative title
A retrospective cohort study.
year
type
H1 - Master's Degree (One Year)
subject
language
English
id
2532248
date added to LUP
2012-05-04 14:25:36
date last changed
2015-12-14 13:21:26
@misc{2532248,
  abstract     = {Studies has shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is inadequate and that there is a treatment difference between genders. The aim of this study was to examine prehospital caregiver¡¯s adherence to treatment guidelines for patients with non-traumatic chest pain and compare treatment frequencies between men and women in a region in southern Sweden.  Methods: A retrospective cohort study, including 862 medical records, where the prehospital caregiver¡¯s primary assessment was non-traumatic acute chest pain, was reviewed.  The time period examined was from January first until last December 2009. Data of gender, age, time of day, frequencies of intravenous lines and specific treatment guidelines including; oxygen, acetylsalicylic acid, sublingual trinitrate glycerin, twelve lead electrocardiograms, pain assessment, and intravenous analgesia was obtained. Results were presented using descriptive statistics according to numbers of patients, mean, median, standard deviation and quartiles when appropriate. Adherence to present guidelines were described into following values; < or equal to 20% = Poor, 21 ¨C 40% = Fair, 41 ¨C 60% = Moderate, 61 ¨C 80% = Good and 81 ¨C 100% = Very good.Results: Of the 862 included medical records, 401 were women and 461 were men. Women¡¯s mean age was 71¡À16 versus men¡¯s 69¡À14, respectively (p<0.05). Twenty-three percent of the patient¡¯s received ¡Ý10 liters of oxygen (men versus women, ns). Sixty-nine percent received treatment with sublingual glyceryl trinitrate, whereas 58% percent of the patients received acetylsalicylic acid (men versus women, p<0.05). Ninety five percent of the patients had a twelve lead electrocardiogram obtained and 40% had their pain assessed with pain scales before treatment with analgesia (men versus women, p<0.05) and 37% after treatment (men versus women, ns). Sixty-seven percent received an intravenous line (men versus women, p<0.05) whereas 10% received Morphine sulphate and 1% received ¦Â-blocker, respectively (men versus women, ns). A significant difference were found in time of day for prehospital emergency care (p<0.05).Conclusions: We conclude that adherence to treatment guidelines vary between the different variables studied, ranging from fair (¡Ý10L Oxygen) to very good (obtaining electrocardiogram). We also conclude differences in treatment between women and men.},
  author       = {Byrsell, Fredrik and Regnell, Mattias},
  language     = {eng},
  note         = {Student Paper},
  title        = {Prehospital caregiver's adherence to treatment guidelines for patients with non-traumatic acute chest pain},
  year         = {2011},
}