ความถูกต้องของการวินิจฉัยภาวะหัวใจหยุดเต้นนอกโรงพยาบาลโดยผู้จ่ายงานปฏิบัติการฉุกเฉิน

Sunisa Taja; Parinya Tianwibool; Krongkarn Sutham; Wiput Laosuksri; Rudklao Sairai; Weerapont Kaewpaengchan; Cherdpong Panya; Borwon Wittayachamnankul

Authors

Sunisa Taja Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Parinya Tianwibool Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Krongkarn Sutham Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Wiput Laosuksri Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Rudklao Sairai Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University
Weerapont Kaewpaengchan Emergency Medical Service and Referral Center, Maharaj Nakorn Chiang Mai Hospital
Cherdpong Panya Emergency Medical Service and Referral Center, Maharaj Nakorn Chiang Mai Hospital
Borwon Wittayachamnankul Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University

Keywords:

cardiac arrest, emergency medical dispatchers, emergency medical service center

Abstract

Background and Rationale: Previous studies showed that emergency medical dispatcher (EMD) infrequently made a correct diagnosis. We found no similar study in Thailand. This study aimed to evaluate the accuracy of out-of-hospital cardiac arrest (OHCA) diagnosis made by EMD. Methodology: This was a retrospective study. We reviewed emergency response record from Maharaj Nakorn Chiang Mai Hospital EMS unit and all records with the diagnosis of OHCA made by EMD at Chiang Mai Province EMS center from 2011 through 2018. Results: In total, 276 medical records were reviewed. The mean age was 55.3+20.5 years, 72.1% were male, 272 patients had cardiac arrest upon arrival of the EMS team, whereas 4 patients had other conditions. Among these 272 patients, 116 patients (42.6%) were diagnosed with OHCA by EMD; whereas 86 patients (31.6%) were diagnosed with unconsciousness, 22 (8.1%) with traffic accident, and 48 (17.6%) with other conditions. The EMD made a diagnosis of OHCA in 120 out of 272 patients, with the sensitivity of 42.6%, and positive predictive value 96.7%. Conclusion: EMD’s diagnosis of OHCA was inaccurate. However, the diagnosis of OHCA made by EMD had high probability.

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