Henrik Andersson1, Andreas Ullgren2, Mats Holmberg3, Thomas Karlsson4, Johan Herlitz5, Birgitta Wireklint Sundström5. 1. PreHospen - Centre for Prehospital Research, University of Borås, Sweden; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden. Electronic address: henrik.andersson@hb.se. 2. Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden; Emergency Medical Service System, Skaraborg Hospital, Skövde, Sweden. 3. PreHospen - Centre for Prehospital Research, University of Borås, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden. 4. Centre for Applied Biostatistics, Occupational and Environmental Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. 5. PreHospen - Centre for Prehospital Research, University of Borås, Sweden; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden.
Abstract
INTRODUCTION: Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome. METHODS: This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008-2010. RESULTS: In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38% and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presence of dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis of acute myocardial infarction (AMI). CONCLUSION: This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and serious diagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influence the ANs' assessment and that special education in cardiovascular nursing is required.
INTRODUCTION: Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome. METHODS: This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008-2010. RESULTS: In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38% and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presence of dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis of acute myocardial infarction (AMI). CONCLUSION: This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and serious diagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influence the ANs' assessment and that special education in cardiovascular nursing is required.
Authors: C Magnusson; J Gärskog; E Lökholm; J Stenström; R Wetter; C Axelsson; M Andersson Hagiwara; N Packendorff; K Jood; T Karlsson; J Herlitz Journal: BMC Emerg Med Date: 2021-03-25