Concordance between emergency physicians and cardiologists in emergency department
Küçük Resim Yok
Tarih
2009
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Bu çalışmanın amacı, acil servise kardiyovasküler şikâyetlerle getirilen hastaların yönetiminde acil tıp ve kardiyoloji asistanlarının uyumunu ve konsültasyonun etkinliğini değerlendirmektir. Gereç ve Yöntem: Bu ileriye dönük analitik çalışma, üçüncü basamak hastane acil servisi ve kardiyoloji kliniğinde bir ay boyunca yapıldı. Acil servise nontravmatik göğüs/sırt ağrısı, çarpıntı, nefes darlığı, senkop, hipertansiyon yakınmalarıyla başvuran, kardiyak arrest veya ani ölüm ile acil servise getirilen, herhangi bir nedenle kardiyoloji konsültasyonu istenen veya kardiyak takibe alınan 18 yaş üstü 240 hasta, bir ay boyunca çalışmaya alındı. Acil servis hekimleri ile kardiyologlar arasındaki ilişki ön tanı, uygun ön tanıyı yapmak için geçen süre, uygun bir yönetim planı yapma, uygun bir yönetim planı yapmak için geçen süre ve uygun sonuç tanısı açısından değerlendirildi. Bulgular: 195 hastanın 70’ine (%35,9) kardiyoloji konsültasyonu istendi. Uygun kardiyoloji konsültasyon oranı %92,2 (180/195) saptandı. Acil tıp hekimlerinin 4 (%2,2) hastada uygunsuz pozitif ve 11 (%5,6) hastada uygunsuz negatif konsültasyon istedikleri görüldü. Konsülte edilen hastalarda kardiyoloji hekimleriyle, acil tıp hekimlerinin ön tanı, ön tanı süresi, uygun hasta planı çizebilme, hasta planlama süreleri ve son tanı uygunluğu açısından fark saptanmadı (sırasıyla p=0,125, p=0,50, p=0,063, p=0,063, p=0,063). Acil tıp hekimleri tarafından konsültasyon istenmeyen hastaların yönetiminde saptanan hata oranı, konsültasyon istenenlere oranla istatistiksel olarak anlamlı olarak yüksek bulundu (p=0,023). Sonuç: Acil servise kardiyak semptomlar ile başvuran hastaların yönetiminde acil servis hekimleri ile kardiyologlar arasında uyum vardır.
O b j e c t i v e s: The aim of this study was to evaluate the concordance between emergency physicians and cardiol- ogists in the management of patients with cardiovascular complaints and to determine the efficacy of consulta- tions with cardiologist in the emergency department. Materials and Methods: This analytic research project was conducted in a tertiary university hospital emergen- cy department and cardiology clinic during a one-month period. 240 adult patients with possible or equivalent signs of acute coronary syndromes or any other indication for a cardiology consultation in the emergency depart- ment were included. Relationship between emergency physicians and cardiology consultants in initial diagnosis, mean time to make the appropriate initial diagnosis, making an appropriate management plan, mean time to make an appropriate management plan and appropriate final diagnosis were observed. Results: Seventy of 195 (35.9%) patients received consultations by the cardiologist. The rate of appropriate car- diology consultation decisions were 92.2% (180/195). Emergency physicians ordered four (2.2%) inappropriate positive and 11 (5.6%) inappropriate negative consultations. Of the patients who were consultated, there was not any significant discordance between emergency physicians and cardiology consultants in inital diagnosis, in mean time to make the appropriate inital diagnosis, in making an appropriate management plan; in mean time to make an appropriate management plan, in appropriate final diagnosis (p=0.125, p=0.50, p=0.063, p=0.063, p=0.063, respectively). Emergency physicians had a significantly higher error rate in management of cases who did not have consultations (p=0.023). C o n c l u s i o n: Management of patients with cardiac symptoms by emergency medicine residents is concordant with cardiology consultants in the emergency department.
O b j e c t i v e s: The aim of this study was to evaluate the concordance between emergency physicians and cardiol- ogists in the management of patients with cardiovascular complaints and to determine the efficacy of consulta- tions with cardiologist in the emergency department. Materials and Methods: This analytic research project was conducted in a tertiary university hospital emergen- cy department and cardiology clinic during a one-month period. 240 adult patients with possible or equivalent signs of acute coronary syndromes or any other indication for a cardiology consultation in the emergency depart- ment were included. Relationship between emergency physicians and cardiology consultants in initial diagnosis, mean time to make the appropriate initial diagnosis, making an appropriate management plan, mean time to make an appropriate management plan and appropriate final diagnosis were observed. Results: Seventy of 195 (35.9%) patients received consultations by the cardiologist. The rate of appropriate car- diology consultation decisions were 92.2% (180/195). Emergency physicians ordered four (2.2%) inappropriate positive and 11 (5.6%) inappropriate negative consultations. Of the patients who were consultated, there was not any significant discordance between emergency physicians and cardiology consultants in inital diagnosis, in mean time to make the appropriate inital diagnosis, in making an appropriate management plan; in mean time to make an appropriate management plan, in appropriate final diagnosis (p=0.125, p=0.50, p=0.063, p=0.063, p=0.063, respectively). Emergency physicians had a significantly higher error rate in management of cases who did not have consultations (p=0.023). C o n c l u s i o n: Management of patients with cardiac symptoms by emergency medicine residents is concordant with cardiology consultants in the emergency department.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Türkiye Acil Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
1
