Factors Influencing the Sudden Deterioration of Emergency Critical Patients in Pre-hospital Care Period
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Abstract
The aim of this study was to determine the factors influencing clinical deterioration during the prehospital care phase in critically ill patients who used the emergency medical system in Phrae province. This cross-sectional analytical study included 299 patients who were categorized as " red" (emergency) and "yellow" (urgent) by telephone triage, received on-site care from emergency medical personnel, and were transferred to Phrae Hospital. Data were collected retrospectively by reviewing patients' medical records and referral documentation from November 2019 to April 2020. Data were analyzed using t-test, Wilcoxon rank sum test and logistic regression analysis. The results showed that 25.63% of participants developed clinical deterioration. In the logistic regression analysis, patients over 60 years of age had a 6.16-fold higher risk of clinical deterioration (95% CI = 2.07-18.31). Patients with one underlying disease and two or more underlying diseases had a 3.82-fold risk (95% CI = 1.63-8.96) and a 3.51-fold risk (95% CI = 1.23-10.06) of clinical deterioration, respectively. Similarly, an on-scene of systolic blood pressure less than 90 mmHg resulted in a 7.73-fold risk of clinical deterioration (95% CI = 2.52-23.69). On-scene of the time greater than 10 minutes resulted in a 2.09-fold risk of clinical deterioration (95% CI = 1.04-1.16). These findings can be used to develop a guide for healthcare providers for on-scene assessment and care to prevent the occurrence of clinical deterioration in critically ill patients during a prehospital crisis.
Article Details
บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
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