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Paramedic accuracy in using a decision support algorithm when recognising adult death: a prospective cohort study.

T Jones¹, M Woollard

¹Welsh Ambulance Services NHS Trust, Pontypool, UK. Tim.jones20@btopenworld.com

Emergency Medicine Journal : EMJ

|September 5, 2003

Summary

Paramedics accurately used a decision support algorithm for recognizing adult death, with a low error rate. This suggests current protocols are effective, potentially improving patient care and resource allocation in emergency medical services.

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Area of Science:

Emergency Medicine
Clinical Decision Support Systems

Background:

Out-of-hospital cardiac arrest with non-shockable rhythms has poor survival rates.
Advanced life support and rapid transport pose risks.
Decision support algorithms aid paramedics in recognizing adult death.

Purpose of the Study:

To assess the accuracy of paramedics using a decision support algorithm for recognizing adult death (ROAD).

Main Methods:

Prospective cohort study of 188 ROAD events over 16 months (November 1999 - February 2001).

Main Results:

13 errors (6.9%) occurred in 188 ROAD applications.
One adverse incident (0.5%) was associated with ROAD use.
High accuracy observed even when considering unavailable ECG data.

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Conclusions:

Paramedics can accurately apply decision support algorithms for recognizing adult death.
Medical practitioner attendance for death confirmation may be inappropriate and prolong on-scene times.
Further research needed to confirm suitability and identification rates for ROAD.