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.
ABSTRACT
Emilia-Romagna was one of the most affected Italian regions during the COVID-19 outbreak in February 2020. We describe here the profound regional, provincial and municipal changes in response to the COVID-19 pandemic, to cope with the numbers of patients presenting with COVID-19 illness, as well as coping with the ongoing need to care for patients presenting with non-COVID-19 emergencies. We focus on the structural and functional changes in one particular hospital within the city of Bologna, the regional capital, which acted as the central emergency hub for time-sensitive pathologies for the province of Bologna. Finally, we present the admissions profile to our emergency department in relation to the massive increase of infected patients observed in our region as well as the organisational response to prepare for the second wave of the pandemic.
Subject(s)
COVID-19/epidemiology , Disease Outbreaks , Emergency Medical Services/organization & administration , Emergency Service, Hospital/organization & administration , Air Ambulances , COVID-19/therapy , Critical Care/organization & administration , Hospital Restructuring , Hospitals, Urban/organization & administration , Humans , Intensive Care Units/organization & administration , Italy/epidemiology , Operating Rooms/organization & administration , Personal Protective EquipmentSubject(s)
COVID-19/epidemiology , Cardiopulmonary Resuscitation/methods , Emergency Medical Services/statistics & numerical data , Out-of-Hospital Cardiac Arrest/epidemiology , Pandemics , Aged , COVID-19/complications , Female , Humans , Incidence , Italy/epidemiology , Male , Out-of-Hospital Cardiac Arrest/etiology , Out-of-Hospital Cardiac Arrest/therapy , Retrospective Studies , SARS-CoV-2 , Survival Rate/trendsSubject(s)
COVID-19/prevention & control , Emergency Medical Services/methods , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Wounds and Injuries/therapy , COVID-19/complications , COVID-19/transmission , Emergency Medical Services/organization & administration , Emergency Medical Services/trends , Humans , Infection Control/instrumentation , Italy , Personal Protective Equipment , Wounds and Injuries/complicationsSubject(s)
Coronavirus , Emergency Medical Services , Betacoronavirus , COVID-19 , Coronavirus Infections , Humans , Italy , Pandemics , Pneumonia, Viral , SARS-CoV-2ABSTRACT
Italy was the second nation after China to be most involved into the COVID-19 outbreak. From the beginning, much attention has been attributed to the importance of epidemiological criteria (such as previous contact with confirmed COVID-19 cases, recent journey across China or the northern Italian regions) in order to assess a suspected patient for SARS-CoV-2 infection. Despite this, by now evidences do exist about the possibly huge reservoir of asymptomatic patients and its underestimated ability to spread the infection. Thus, we do believe that when an infectious disease has a big ratio of asymptomatic cases, as for COVID-19, it is simply not safe to rely on epidemiological criteria and we briefly discuss this issue throughout the few new evidences there are about. This article is protected by copyright. All rights reserved.