Comparison of the Final Diagnosis Made by Prehospital Emergency Teams with the Final Diagnosis Made at the Hospital

Abstract

Introduction: In order to know the adequacy and effectiveness of
the prehospital emergency teams a descriptive study was conducted in Cova da Beira.
Material and Methods: We compared the final diagnosis made by
the physician in the prehospital emergency team with the final diagnosis made at the hospital. Severity/complexity of the conditions
that led to activation of prehospital emergency teams was assessed
using the patient’s final destination at the hospital.
Results: We found that in all groups of the International Classification of Diseases there was an overdiagnosis made by the prehospital emergency staff, in which the asthma diagnosis was the one that
presented the biggest difference when compared to the hospital
diagnosis. In the case of prehospital diagnosis of stroke we found
that 30.8% (12/39) of these cases were not in fact primary neurologic disorders but oxygenation and/or hemodynamic problems
with neurologic symptoms. In the circulatory system, 51.7% (15/29)
of the diagnostic hypotheses posed as unstable angina were not
related with the coronary fast-track. The most frequent result of
Emergency Department stays was hospital discharge, in all systems except in the respiratory. Therefore, the majority activations
correspond to a mild degree of severity/complexity. Death and hospitalization occurred most frequently in cases related to problems/ diagnosis of the respiratory system.
Conclusion: There is an excessive tendency to establish specific nosologic diagnosis. Prehospital diagnostic hypothesis should be
less nosological and more problem oriented. Problems of nervous system, circulatory and injuries / poisonings are the most prevalent in this region's prehospital activity, but respiratory problems are the
system with poorest diagnostic performance and dimmest prognosis. Therefore, respiratory problems arise as a priority issue in VMER attention and preparation.