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Petersen JAD, Blomberg SN, Lippert F, Christensen HC. Characteristics of low acuity prehospital emergency patients with 48-h mortality, an observational cohort study. Scand J Trauma Resusc Emerg Med 2022; 30:64. [PMID: 36482471 PMCID: PMC9730555 DOI: 10.1186/s13049-022-01048-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Every year an emergency medical technician or paramedic treats and transports up to several hundred patients. Only some patients are acutely seriously ill, and a few of these show only discrete signs and symptoms of their condition. This study aims to describe patients who died within 48 h of being admitted non-emergently to hospital by ambulance, examine the extent to which critically ill patients are recognized prehospitally, and identify clinical warning signs that might be frequently overlooked. METHOD Registry based follow-up study on patients receiving an ambulance from the Copenhagen EMS in 2018. Data was included regarding the dispatch of the ambulance from the emergency services disposition system, ICD-10 hospital admission diagnoses from the National Patient Register, 48-h mortality from the Central Person Register and assessment and treatment in the ambulance by reviewing the electronic pre-hospital patient record. RESULTS In 2018 2279 patients died within 48 h after contact with the EMS, 435 cases met inclusion criteria. The patients' median age was 83 years (IQR 75-90), and 374 (86.0%) had one or more underlying serious medical conditions. A triage category based on vitals and presentation was not assigned by the EMS in 286 (68.9%) cases, of which 38 (13.3%) would meet red and 126 (44.1%) orange criteria. For 409 (94.0%) patients, it was estimated that death within 48 h could not have been avoided prehospitally, and for 26 (6.0%) patients it was uncertain. We found 27 patients with acute aortic syndrome as admission diagnosis, of these nine (33.3%) had not been admitted urgently to a hospital with vascular surgery specialty. CONCLUSIONS It was estimated that death within 48 h could generally not be avoided prehospitally. The patients' median age was 83 years, and they often had serious comorbidity. Patients whose vital parameters met red or orange triage criteria were to a lesser degree triaged prehospitally, compared to patients in the yellow or green categories. Patients with acute aortic syndrome were not recognized by EMS 33.3% of the time.
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Affiliation(s)
- Jesper A. Dyhring Petersen
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Nikolaj Blomberg
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.512919.7Copenhagen Emergency Medical Services, Copenhagen, Denmark
| | - Freddy Lippert
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.512919.7Copenhagen Emergency Medical Services, Copenhagen, Denmark
| | - Helle Collatz Christensen
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark ,grid.512919.7Copenhagen Emergency Medical Services, Copenhagen, Denmark ,Danish Clinical Quality Program (RKKP), National Clinical Registries, Copenhagen, Denmark
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Riera-López N, Gaetano-Gil A, Martínez-Gómez J, Rodríguez-Rodil N, Fernández-Félix BM, Rodríguez-Pardo J, Cuadrado-Hernández C, Martínez-González EP, Villar-Arias A, Gutiérrez-Sánchez F, Busca-Ostolaza P, Montero-Ruiz E, Díez-Tejedor E, Zamora J, Fuentes-Gimeno B. The COVID-19 pandemic effect on the prehospital Madrid stroke code metrics and diagnostic accuracy. PLoS One 2022; 17:e0275831. [PMID: 36215281 PMCID: PMC9550046 DOI: 10.1371/journal.pone.0275831] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Only very few studies have investigated the effect of the COVID-19 pandemic on the pre-hospital stroke code protocol. During the first wave, Spain was one of the most affected countries by the SARS-CoV-2 coronavirus disease pandemic. This health catastrophe overshadowed other pathologies, such as acute stroke, the leading cause of death among women and the leading cause of disability among adults. Any interference in the stroke code protocol can delay the administration of reperfusion treatment for acute ischemic strokes, leading to a worse patient prognosis. We aimed to compare the performance of the stroke code during the first wave of the pandemic with the same period of the previous year. METHODS This was a multicentre interrupted time-series observational study of the cohort of stroke codes of SUMMA 112 and of the ten hospitals with a stroke unit in the Community of Madrid. We established two groups according to the date on which they were attended: the first during the dates with the highest daily cumulative incidence of the first wave of the COVID-19 (from February 27 to June 15, 2020), and the second, the same period of the previous year (from February 27 to June 15, 2019). To assess the performance of the stroke code, we compared each of the pre-hospital emergency service time periods, the diagnostic accuracy (proportion of stroke codes with a final diagnosis of acute stroke out of the total), the proportion of patients treated with reperfusion therapies, and the in-hospital mortality. RESULTS SUMMA 112 activated the stroke code in 966 patients (514 in the pre-pandemic group and 452 pandemic). The call management time increased by 9% (95% CI: -0.11; 0.91; p value = 0.02), and the time on scene increased by 12% (95% CI: 2.49; 5.93; p value = <0.01). Diagnostic accuracy, and the proportion of patients treated with reperfusion therapies remained stable. In-hospital mortality decreased by 4% (p = 0.05). CONCLUSIONS During the first wave, a prolongation of the time "on the scene" of the management of the 112 calls, and of the hospital admission was observed. Prehospital diagnostic accuracy and the proportion of patients treated at the hospital level with intravenous thrombolysis or mechanical thrombectomy were not altered with respect to the previous year, showing the resilience of the stroke network and the emergency medical service.
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Affiliation(s)
- Nicolás Riera-López
- Stroke Commission, Emergency Medical Service of Madrid (SUMMA 112), Madrid, Spain
- * E-mail:
| | - Andrea Gaetano-Gil
- Clinical Biostatistics Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
| | - José Martínez-Gómez
- IT Department, Emergency Medical Service of Madrid (SUMMA 112), Madrid, Spain
| | | | - Borja M. Fernández-Félix
- Clinical Biostatistics Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jorge Rodríguez-Pardo
- Department of Neurology and Stroke Centre, IdiPAZ Health Research Institute (La Paz University Hospital, Autonomous University of Madrid), Madrid, Spain
| | | | | | - Alicia Villar-Arias
- Management Department, Emergency Medical Service of Madrid (SUMMA 112), Madrid, Spain
| | | | - Pablo Busca-Ostolaza
- Management Department, Emergency Medical Service of Madrid (SUMMA 112), Madrid, Spain
| | | | - Exuperio Díez-Tejedor
- Department of Neurology and Stroke Centre, IdiPAZ Health Research Institute (La Paz University Hospital, Autonomous University of Madrid), Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Ramón y Cajal University Hospital, IRYCIS, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Blanca Fuentes-Gimeno
- Department of Neurology and Stroke Centre, IdiPAZ Health Research Institute (La Paz University Hospital, Autonomous University of Madrid), Madrid, Spain
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Spörl P, Beckers SK, Rossaint R, Felzen M, Schröder H. Shedding light into the black box of out-of-hospital respiratory distress—A retrospective cohort analysis of discharge diagnoses, prehospital diagnostic accuracy, and predictors of mortality. PLoS One 2022; 17:e0271982. [PMID: 35921383 PMCID: PMC9348717 DOI: 10.1371/journal.pone.0271982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Although respiratory distress is one of the most common complaints of patients requiring emergency medical services (EMS), there is a lack of evidence on important aspects. Objectives Our study aims to determine the accuracy of EMS physician diagnostics in the out-of-hospital setting, identify examination findings that correlate with diagnoses, investigate hospital mortality, and identify mortality-associated predictors. Methods This retrospective observational study examined EMS encounters between December 2015 and May 2016 in the city of Aachen, Germany, in which an EMS physician was present at the scene. Adult patients were included if the EMS physician initially detected dyspnea, low oxygen saturation, or pathological auscultation findings at the scene (n = 719). The analyses were performed by linking out-of-hospital data to hospital records and using binary logistic regressions. Results The overall diagnostic accuracy was 69.9% (485/694). The highest diagnostic accuracies were observed in asthma (15/15; 100%), hypertensive crisis (28/33; 84.4%), and COPD exacerbation (114/138; 82.6%), lowest accuracies were observed in pneumonia (70/142; 49.3%), pulmonary embolism (8/18; 44.4%), and urinary tract infection (14/35; 40%). The overall hospital mortality rate was 13.8% (99/719). The highest hospital mortality rates were seen in pneumonia (44/142; 31%) and urinary tract infection (7/35; 20%). Identified risk factors for hospital mortality were metabolic acidosis in the initial blood gas analysis (odds ratio (OR) 11.84), the diagnosis of pneumonia (OR 3.22) reduced vigilance (OR 2.58), low oxygen saturation (OR 2.23), and increasing age (OR 1.03 by 1 year increase). Conclusions Our data highlight the diagnostic uncertainties and high mortality in out-of-hospital emergency patients presenting with respiratory distress. Pneumonia was the most common and most frequently misdiagnosed cause and showed highest hospital mortality. The identified predictors could contribute to an early detection of patients at risk.
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Affiliation(s)
- Patrick Spörl
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- Aachen Institute for Rescue Management and Public Safety, University Hospital RWTH Aachen, Aachen, Germany
- * E-mail:
| | - Stefan K. Beckers
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- Aachen Institute for Rescue Management and Public Safety, University Hospital RWTH Aachen, Aachen, Germany
- Medical Direction, Emergency Medical Service, Aachen, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Marc Felzen
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- Aachen Institute for Rescue Management and Public Safety, University Hospital RWTH Aachen, Aachen, Germany
- Medical Direction, Emergency Medical Service, Aachen, Germany
| | - Hanna Schröder
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
- Aachen Institute for Rescue Management and Public Safety, University Hospital RWTH Aachen, Aachen, Germany
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Dunand A, Beysard N, Maudet L, Carron PN, Dami F, Piquilloud L, Caillet-Bois D, Pasquier M. Management of respiratory distress following prehospital implementation of noninvasive ventilation in a physician-staffed emergency medical service: a single-center retrospective study. Scand J Trauma Resusc Emerg Med 2021; 29:85. [PMID: 34187538 PMCID: PMC8240431 DOI: 10.1186/s13049-021-00900-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/11/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Noninvasive ventilation (NIV) is recognized as first line ventilatory support for the management of acute pulmonary edema (APE) and chronic obstructive pulmonary disease (COPD) exacerbations. We aimed to study the prehospital management of patients in acute respiratory distress with an indication for NIV and whether they received it or not. METHODS This retrospective study included patients ≥18 years old who were cared for acute respiratory distress in a prehospital setting. Indications for NIV were oxygen saturation (SpO2) <90% and/or respiratory rate (RR) >25/min with a presumptive diagnosis of APE or COPD exacerbation. Study population characteristics, initial and at hospital vital signs, presumptive and definitive diagnosis were analyzed. For patients who received NIV, dyspnea level was evaluated with a dyspnea verbal ordinal scale (D-VOS, 0-10) and arterial blood gas (ABG) values were obtained at hospital arrival. RESULTS Among the 187 consecutive patients included in the study, most (n = 105, 56%) had experienced APE or COPD exacerbation, and 56 (30%) received NIV. In comparison with patients without NIV, those treated with NIV had a higher initial RR (35 ± 8/min vs 29 ± 10/min, p < 0.0001) and a lower SpO2 (79 ± 10 vs 88 ± 11, p < 0.0001). The level of dyspnea was significantly reduced for patients treated with NIV (on-scene D-VOS 8.4 ± 1.7 vs 4.4 ± 1.8 at admission, p < 0.0001). Among the 131 patients not treated with NIV, 41 (31%) had an indication. In the latter group, initial SpO2 was 80 ± 10% in the NIV group versus 86 ± 11% in the non-NIV group (p = 0.0006). NIV was interrupted in 9 (16%) patients due to either discomfort (n = 5), technical problem (n = 2), persistent desaturation (n = 1), or vomiting (n = 1). CONCLUSIONS The results of this study contribute to a better understanding of the prehospital management of patients who present with acute respiratory distress and an indication for NIV. NIV was started on clinically more severe patients, even if predefined criteria to start NIV were present. NIV allows to improve vital signs and D-VOS in those patients. A prospective study could further elucidate why patients with a suspected diagnosis of APE and COPD are not treated with NIV, as well as the clinical impact of the different strategies. TRIAL REGISTRATION The study was approved by our institutional ethical committee ( CER-VD 2020-01363 ).
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Affiliation(s)
- Adeline Dunand
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.,Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Nicolas Beysard
- Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Ludovic Maudet
- Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Pierre-Nicolas Carron
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.,Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Fabrice Dami
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.,Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Lise Piquilloud
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland.,Adult Intensive Care Unit, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - David Caillet-Bois
- Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Mathieu Pasquier
- Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011, Lausanne, Switzerland. .,Department of Emergency Medicine, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
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5
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Martín-Rodríguez F, Sanz-García A, Del Pozo Vegas C, Ortega GJ, Castro Villamor MA, López-Izquierdo R. Time for a prehospital-modified sequential organ failure assessment score: An ambulance-Based cohort study. Am J Emerg Med 2021; 49:331-337. [PMID: 34224955 DOI: 10.1016/j.ajem.2021.06.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To adapt the Sequential Organ Failure Assessment (SOFA) score to fit the prehospital care needs; to do that, the SOFA was modified by replacing platelets and bilirubin, by lactate, and tested this modified SOFA (mSOFA) score in its prognostic capacity to assess the mortality-risk at 2 days since the first Emergency Medical Service (EMS) contact. METHODS Prospective, multicentric, EMS-delivery, ambulance-based, pragmatic cohort study of adults with acute diseases, referred to two tertiary care hospitals (Spain), between January 1st and December 31st, 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using the derivation cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation cohort. RESULTS A total of 1114 participants comprised two separated cohorts recruited from 15 ambulance stations. The 2-day mortality rate (from any cause) was 5.9% (66 cases). The predictive validity of the mSOFA score was assessed by the calculation of the AUC of ROC in the validation cohort, resulting in an AUC of 0.946 (95% CI, 0.913-0.978, p < .001), with a positive likelihood ratio was 23.3 (95% CI, 0.32-46.2). CONCLUSIONS Scoring systems are now a reality in prehospital care, and the mSOFA score assesses multiorgan dysfunction in a simple and agile manner either bedside or en route. Patients with acute disease and an mSOFA score greater than 6 points transferred with high priority by EMS represent a high early mortality group. TRIAL REGISTRATION ISRCTN48326533, Registered Octuber 312,019, Prospectively registered (doi:https://doi.org/10.1186/ISRCTN48326533).
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Affiliation(s)
- Francisco Martín-Rodríguez
- Unidad Móvil de Emergencias Valladolid I, Gerencia de Emergencias Sanitarias, Gerencia Regional de Salud de Castilla y León (SACYL), Spain; Centro de Simulación Clínica Avanzada, Departamento de Medicina, Dermatología y Toxicología, Universidad de Valladolid, Spain.
| | - Ancor Sanz-García
- Unidad de Análisis de Datos (UAD) del Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain.
| | - Carlos Del Pozo Vegas
- Servicio de Urgencias, Hospital Clínico Universitario de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), Spain
| | - Guillermo J Ortega
- Unidad de Análisis de Datos (UAD) del Instituto de Investigación Sanitaria del Hospital de la Princesa (IIS-IP), Madrid, Spain
| | - Miguel A Castro Villamor
- Centro de Simulación Clínica Avanzada, Departamento de Medicina, Dermatología y Toxicología, Universidad de Valladolid, Spain
| | - Raúl López-Izquierdo
- Servicio de Urgencias, Hospital Universitario Rio Hortega de Valladolid, Gerencia Regional de Salud de Castilla y León (SACYL), Spain
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Suppan L, Chan M, Gartner B, Regard S, Campana M, Chatellard G, Cottet P, Larribau R, Sarasin FP, Niquille M. Evaluation of a Prehospital Rotation by Senior Residents: A Web-Based Survey. Healthcare (Basel) 2020; 9:healthcare9010024. [PMID: 33383633 PMCID: PMC7824315 DOI: 10.3390/healthcare9010024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/14/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022] Open
Abstract
The added value of prehospital emergency medicine is usually assessed by measuring patient-centered outcomes. Prehospital rotations might however also help senior residents acquire specific skills and knowledge. To assess the perceived added value of the prehospital rotation in comparison with other rotations, we analyzed web-based questionnaires sent between September 2011 and August 2020 to senior residents who had just completed a prehospital rotation. The primary outcome was the perceived benefit of the prehospital rotation in comparison with other rotations regarding technical and non-technical skills. Secondary outcomes included resident satisfaction regarding the prehospital rotation and regarding supervision. A pre-specified subgroup analysis was performed to search for differences according to the participants’ service of origin (anesthesiology, emergency medicine, or internal medicine). The completion rate was of 71.5% (113/158), and 91 surveys were analyzed. Most senior residents found the prehospital rotation either more beneficial or much more beneficial than other rotations regarding the acquisition of technical and non-technical skills. Anesthesiology residents reported less benefits than other residents regarding pharmacological knowledge acquisition and confidence as to their ability to manage emergency situations. Simulation studies should now be carried out to confirm these findings.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
- Correspondence:
| | - Michèle Chan
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - Birgit Gartner
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - Simon Regard
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - Mathieu Campana
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
- Division of Anaesthesiology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland
| | - Ghislaine Chatellard
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
- Division of Anaesthesiology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland
| | - Philippe Cottet
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - Robert Larribau
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - François Pierre Sarasin
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
| | - Marc Niquille
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine University of Geneva, Geneva University Hospitals, CH-1211 Geneva, Switzerland; (M.C.); (B.G.); (S.R.); (M.C.); (G.C.); (P.C.); (R.L.); (F.P.S.); (M.N.)
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Einfluss patientenspezifischer Faktoren auf die Notarztdiagnose. Notf Rett Med 2020. [DOI: 10.1007/s10049-019-00633-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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