Federico Semeraro1, Giovanni Corona2, Tommaso Scquizzato3,4, Lorenzo Gamberini1, Anna Valentini5, Marco Tartaglione1, Andrea Scapigliati6, Giuseppe Ristagno7,8, Carmela Martella5, Carlo Descovich9, Cosimo Picoco1, Giovanni Gordini1. 1. Department of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, Italy. 2. Endocrinology Unit, Maggiore-Bellaria Hospital, 3-40139 Bologna, Italy. 3. Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy. 4. School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy. 5. Department of Medical and Surgical Sciences, Alma Mater Studiorum University, 40126 Bologna, Italy. 6. Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy. 7. Department of Pathophysiology and Transplantation, University of Milan, 00168 Milan, Italy. 8. Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, 20122 Milan, Italy. 9. Clinical Governance and Quality Unit, Bologna Local Healthcare Authority Staff, 40133 Bologna, Italy.
Abstract
BACKGROUND: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients' conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients and to trigger appropriate care in the pre-hospital setting. METHODS: A single centre, longitudinal, prospective study was carried out between July and August 2020 in the EMS service of Bologna. Home patients with age ≥ 18 years old were included in the study. The exclusion criterion was the impossibility to collect all the parameters needed to measure NEWS. RESULTS: A total of 654 patients were enrolled in the study. The recorded NEWS values increased along with the severity of dispatch priority code, the EMS return code, the emergency department triage code, and with patients' age (r = 0.135; p = 0.001). The aggregated value of NEWS was associated with an increased risk of hospitalization (OR = 1.30 (1.17; 1.34); p < 0.0001). CONCLUSION: This study showed that the use of NEWS in the urgent and emergency care services can help patient assessment while not affecting EMS crew operation and might assist decision making in terms of severity-code assignment and resources utilization.
BACKGROUND: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients' conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients and to trigger appropriate care in the pre-hospital setting. METHODS: A single centre, longitudinal, prospective study was carried out between July and August 2020 in the EMS service of Bologna. Home patients with age ≥ 18 years old were included in the study. The exclusion criterion was the impossibility to collect all the parameters needed to measure NEWS. RESULTS: A total of 654 patients were enrolled in the study. The recorded NEWS values increased along with the severity of dispatch priority code, the EMS return code, the emergency department triage code, and with patients' age (r = 0.135; p = 0.001). The aggregated value of NEWS was associated with an increased risk of hospitalization (OR = 1.30 (1.17; 1.34); p < 0.0001). CONCLUSION: This study showed that the use of NEWS in the urgent and emergency care services can help patient assessment while not affecting EMS crew operation and might assist decision making in terms of severity-code assignment and resources utilization.
Entities:
Keywords:
EMS; NEWS; National Early Warning Score; ambulance; apps; cardiac arrest; out-of-hospital