Résumé
Objective:To observe the effect of two different screening scales used by 120 dispatchers to early identify stroke patients and give telephone guidance for treatment.Methods:From October 2018 to August 2019, 2 027 stroke and suspect stroke patients who called the Kaifeng 120 Emergency Center were enrolled. The differences in the final positive rate of stroke diagnosis and the incidence of adverse events were compared and analyzed in 1 020 cases using recognition of stroke in the emergency room (ROSIER) and 1 007 cases using facial drooping, arm weakness, speech difficulties and time (FAST) scale scores for telephone guidance.Results:The positive rate of stroke identification in ROSIER score group was higher than that in FAST score group [31.4% (320/1 020) vs. 29.3% (295/1 007)], the false report rate was significantly lower than that in FAST score group [14.9% (152/1 020) vs. 18.8% (189/1 007), P < 0.05], the incidence of adverse events caused by vomiting, falling from bed and convulsions in ROSIER score group were lower than those in FAST score group [0.5% (1/208) vs. 2.2% (4/185), 0% (0/26) vs. 20.0% (2/10), 2.1% (1/48) vs. 10.3% (3/29)], however, the incidence of adverse events caused by falling out of bed was significantly lower ( P < 0.05). The incidence of total adverse events in ROSIER score group was significantly lower than that in FAST score group [0.7% (2/305) vs. 3.8% (9/235), P < 0.05]. The time of FAST score group was shorter than that of ROSIER score group (minutes: 1.2±0.2 vs. 2.5±0.3), but the difference was not statistically significant ( P > 0.05). Conclusions:Two different scales can be used to early identify stroke patients and provide timely pre-hospital guidance, thus reduce the incidence of adverse events. Although the ROSIER score takes longer time, the dispatchers guide the patients by phone which does not affect the dispatch time.
Résumé
Objectives To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status,and to understand the current situation of TCPR cognition of EMS personnel in China.Methods This study is a multicenter crosssectional survey.The method of multi-level convenient sampling was adopted,and the test reliability and split half reliability of the questionnaire was tested.Questionnaire survey and data collection were conducted from December 2018 to June 2019.The ethical approval number is M2018264.SPSS 20.0 was used for analysis.x2 test was used to analyze the differences between groups.Results A total of 1191 electronic questionnaires were collected.Of them,80.94％ respondents knew TCPR,97.82％ respondents thought that TCPR should be implemented in cardiac arrest,36.62％ respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR,and TCPR training courses were set up in the emergency department which recruited 25.83％ respondents.Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69％ vs 7.89％,P=0.048),of TCPR need ncluding guidance of chest compression (92.45％ vs 87.49％,P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42％ vs 74.87％,P=0.029) than those in underdeveloped areas,but there was no significant difference in other indicators (P＞0.05).Conclusions TCPR knowledge of EMS personnel in China is unsatisfactory.Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone,TCPR content and bystander cardiopulmonary resuscitation quality monitoring.There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China.