Feasibility and reliability of prehospital triage in patients with thoracic complaints/pain appropriate to a suspicious ACS
ID
Bron
Verkorte titel
Aandoening
pijn op de borst klachten
ACS
Chest pain
ACS
Ondersteuning
Ambulancezorg Rotterdam-Rijnmond AZRR
Breslau 2
2993 LT Barendrecht
E-mail: nvanderwaarden@azrr.nl
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Mace after 30 days, 3 months and 1 year<br>
Mace is defined as acute myocardial infraction, CAG, PCI, CABG or death
Achtergrond van het onderzoek
It seems obvious that a significant part of all ambulances deployments which presents themselves as thoracic complaints may be of a cardiologic nature. Due to the limited prehospital diagnostic possibilities of these category patients (who present themselves with thoracic pain associated with acute coronary syndrome (ACS), it is not possible to confirm or exclude an ACS in this first phase. The result is that this patients can be transported to a hospital which is not able to provide the optimal care (non intervention versus intervention center).
The prehospital confirmation or exclusion of an ACS can positively contribute to decisionmaking and the quality of care. Based on risk stratification using the HEART score, the ambulancenurse can determine the risk profile of the patient and rule out or diagnose of ACS. The HEART score consists of five components, History, EKG, Age, Risk Factors and Troponin. Each part is scored and a total score is generated. The HEART score is a validated risk assessment instrument. Determining a troponin is an important part of the standard care for patients with ACS symptoms.
With the implementation of the prehospital HEART score, the Troponin is done in the ambulance or at the patients home. This is expected not only to improve patient safety, but can also have a positive impact on costs and workload.
For this study only feasibility en reliability of the use of HEARTscore is tested in de prehospital phase. one blood sample is taking for troponin, but is blinded on de point of care testing voor de nurses. The treatment is usual care conform LPA 8.1. The blood sample for troponin goes to the laboratorium from the hospital for usual troponin assessment.
Feasibility and reliability of prehospital triage in patients with thoracic complaints/pain appropriate to a suspicious ACS in The Netherlands
Doel van het onderzoek
Feasibility and reliability of prehospital triage in patients with thoracic complaints/pain appropriate to a suspicious ACS
Onderzoeksopzet
in prehospital phase HEART-score
Arrival hospital HEART score
Onderzoeksproduct en/of interventie
blood sample (Troponin) earlier in the proces
Publiek
N.W.P.L. van der Waarden
Breslau 2
Barendrecht 2993 LT
The Netherlands
nvanderwaarden@azrr.nl
Wetenschappelijk
N.W.P.L. van der Waarden
Breslau 2
Barendrecht 2993 LT
The Netherlands
nvanderwaarden@azrr.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
All patients over the age of 18 who, after assessment of the ambulance nurse, need to be transported to the hospital with complaints appropriate to a suspicious ACS
- older than 18 years
- legally capable to give consent
-thoracic pain or complaints appropriate to a suspicious ACS
-Understand the Dutch language sufficiently
-signed informed consent
- transported to Maasstad or Ikazia hospital
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
-legally incapable to give consent or comatose
- incapable to understand the dutch language
- STEMI on EKG
- Missing EKG
- Clear other cause of thoracic pain/complaints (pneumonia, aorta dissection, trauma, pneumothorax etc.)
- impossibility iv venflon
Opzet
Deelname
Opgevolgd door onderstaande (mogelijk meer actuele) registratie
Geen registraties gevonden.
Andere (mogelijk minder actuele) registraties in dit register
Geen registraties gevonden.
In overige registers
| Register | ID |
|---|---|
| NTR-new | NL6429 |
| NTR-old | NTR6606 |
| CCMO | NL62976.101.17 |