Difficulty breathing: agreement of paramedic and emergency physician diagnoses.

摘要

Objective. To determine the diagnostic accuracy of paramedics treating patients who have called an ambulance for "difficulty breathing." Methods. A retrospective study of all ambulance call reports generated by one ambulance over a one-year period with the dispatch complaint of difficulty breathing the call report was compared with the emergency department (ED) physician diagnosis, which was used as the "gold standard." Results. A total of 244 ambulance reports were reviewed. For patients complaining of "difficulty breathing," paramedics achieved 86.4% sensitivity and 86.6% specificity for diagnosing cardiac disease, 71.4% sensitivity and 93.6% specificity for respiratory disease, and 82.1% sensitivity and 91% specificity for other disease processes. There was an interrater agreement of 81.1% between paramedic and ED physician, producing a kappa of 0.71, interpreted as good, approaching excellent, agreement. Conclusion. Paramedics are able to identify the disease process category in patients dispatchedas having difficulty breathing,