Pranas Šerpytis, Urtė Gargalskaitė, Vanda Pumputienė, Tadeušas Rodz, Neringa Karvelytė
Abstract
The aim of this study was to evaluate the skills of emergency physicians (EP) and emergency nurses (EN) in Vilnius city on the triage and diagnosis of acute coronary syndromes (ACS) according to guidelines of the European Society of Cardiology (ESC). Material and Methods: A retrospective analysis was performed in Vilnius Central Ambulance Station. 6195 cards of emergency calls with suspected diagnosis of acute myocardial infarction (AMI) and unstable angina pectoris (UA) were evaluated. Morbidity, hospitalization were our main and points. The patients were divided into two groups according to the qualification of emergency specialist they had contacted with. The differences in the diagnosis and triage between these two groups were analyzed. Results: AMI was suspected for 980 patients: 42,24% women, 57,65% men. UA – for 5215 patients: 51,97% women, 47,98% men. The average age of the women with AMI was 73 years (±10,77), men – 62 years (±13,15), for UA – women 71 years (±12,19), men – 64,4 years (±13,9). Most of the patients were hospitalized to the main Vilnius hospitals. Only those emergency cases who called not from the medical institutions (668 with AMI, 3704 with NAP) were included. They were divided into two groups according to the qualification of emergency specialist. 25% patients with the diagnosis of suspected AMI and 15% with the diagnosis of suspected UA received help from EP and 75% with suspected AMI, 85% – with UA – from EN. 26,04% of EP and 29,86% of EN do not differentiate ECG changes. Conclusions: The diagnosis of suspected AMI was formulated for men more often mean while the diagnosis of suspected UA for women. The difference of age according to sex with suspected AMI significantly differed: men were 10 years younger than women. Compared to EP, EN went to the patients more often, however, prescription of medicaments among EP was more accurate: heparin or low-molecular-weight heparins, beta-blockers and narcotic analgesics they prescribe more often, more over, the rate of NSAIDs prescription is much higher among EN.http://dx.doi.org/10.5200/sm-hs.2013.052Article in Lithuanian
Keyword(s): Acute coronary syndromes; acute myocardial infarction; unstable angina pectoris; emergency physician; emergency nurse; preclinical care; prehospital 12-lead ECG; primary PCI
DOI: 10.5200/sm-hs.2013.051
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