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Does the pandemic medical early warning score system correlate with disposition decisions made at patient contact by emergency care practitioners?
  1. J T Gray1,
  2. K Challen2,3,
  3. L Oughton4
  1. 1Yorkshire Ambulance Service NHS Trust (South), Wakefield, UK
  2. 2Emergency Medicine, Salford Royal Hospitals Trust, Salford, UK
  3. 3University of Sheffield, Sheffield, UK
  4. 4University of Leeds Medical School, Leeds, UK
  1. Correspondence to Dr J T Gray, Yorkshire Ambulance Service NHS Trust (South), Springhill II, Wakefield 41 Business Park, Brindley Way, Wakefield WF2 0XQ, UK; james.gray{at}yas.nhs.uk

Abstract

Objective To assess the performance of the pandemic medical early warning score (PMEWS) in a cohort of adult patients seen in the community by emergency care practitioners (ECP) and its correlation with ECP decision-making to either ‘treat and leave’ or transfer for hospital assessment.

Methods Cases attended by ECP in South Yorkshire in 2007 in which the final ECP working diagnosis was a respiratory condition were retrospectively identified from the Yorkshire Ambulance Service database. The patient report forms were reviewed for the PMEWS variables and scores calculated using the PMEWS system. The outcome measure was management in the community versus transport to hospital. Receiver operating characteristics (ROC) curves were calculated to assess the discrimination of PMEWS.

Results A cohort of 300 patients was assessed. 217 (72%) were aged 65 years or over, and 272 (91%) had either comorbid disease or impaired functional status. 98 (33%) were deemed to need hospital assessment or admission. The ROC curves suggested that there is good correlation between the PMEWS score and the decision to discharge.

Conclusions PMEWS correlates well with decisions to admit to hospital or leave at home made by extended role practitioners in the patient group studied; however, further prospective work is required to further validate early warning scoring systems in prehospital care.

  • Advanced practitioner
  • clinical assessment
  • clinical management
  • emergency ambulance systems
  • emergency care practitioners
  • emergency care systems
  • emergency medical services
  • prehospital emergency care
  • transportation of patients
  • triage

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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