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VOLUME 21 , ISSUE 4 ( 2017 ) > List of Articles

RESEARCH ARTICLE

Development and psychometric evaluation of the pre-hospital medical emergencies early warning scale

Gholamreza Masoumi, Roohangiz Jamshidi-Orak, Hesam Seyedin

Keywords : emergency care, pre-hospital marker, scoring system,Early Warning Scale

Citation Information : Masoumi G, Jamshidi-Orak R, Seyedin H. Development and psychometric evaluation of the pre-hospital medical emergencies early warning scale. Indian J Crit Care Med 2017; 21 (4):205-212.

DOI: 10.4103/ijccm.IJCCM_49_17

License: CC BY-ND 3.0

Published Online: 00-04-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS). Materials and Methods: This mixed-method study was conducted in two phases. In the first phase, a qualitative content analysis study was conducted to identify the predictors of medical patients\' need for pre-hospital EMS and transportation. In the second phase, the face and the content validity as well as the internal consistency of the scale were evaluated. Finally, the items of the scale were scored and scoring system was presented. Results: The final version of the scale contained 22 items and its total score ranged from 0 to 54. Conclusions: Pre-MEWS helps EMS staffs properly understand medical patients\' conditions in pre-hospital environments and accurately identify their need for EMS and transportation.


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  1. Challen K, Walter D. Physiological scoring: An aid to emergency medical services transport decisions? Prehosp Disaster Med 2010;25:320-3.
  2. Lee LL, Yeung KL, Lo WY, Lau YS, Tang SY, Chan JT. Evaluation of a simplified therapeutic intervention scoring system (TISS-28) and the modified early warning score (MEWS) in predicting physiological deterioration during inter-facility transport. Resuscitation 2008;76:47-51.
  3. Moradian MJ, Peyravi MR, Ettehadi R, Pour-Mohammadi K. Response time to emergency cases in Shiraz. Sci J Rescuer Relief 2013;5:30-9.
  4. Ebrahimian AA, Khalesi N, Mohamadi G, Tourdeh M, Naghipour M. Transportation management in pre-hospital emergency whit physiological early warning scores. J Health Adm 2012;15:7-13.
  5. Ebrahimian AA, Shabanikiya HR, Khalesi N. The role of physiological scores for decision making in internal prehospital emergency situations. HealthMed 2012;6:3612-5.
  6. Ebrahimian A, Seyedin H, Jamshidi-Orak R, Masoumi G. Physiological-social scores in predicting outcomes of prehospital internal patients. Emerg Med Int 2014;2014:312189.
  7. Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified early warning score in medical admissions. QJM 2001;94:521-6.
  8. Garcea G, Ganga R, Neal CP, Ong SL, Dennison AR, Berry DP. Preoperative early warning scores can predict in-hospital mortality and critical care admission following emergency surgery. J Surg Res 2010;159:729-34.
  9. Sporer KA, Johnson NJ. Detailed analysis of prehospital interventions in medical priority dispatch system determinants. West J Emerg Med 2011;12:19-29.
  10. Flynn J, Archer F, Morgans A. Sensitivity and specificity of the medical priority dispatch system in detecting cardiac arrest emergency calls in Melbourne. Prehosp Disaster Med 2006;21:72-6.
  11. Myers JB, Hinchey P, Zalkin J. EMS dispatch triage criteria can accurately identify patients without high-acuity illness or injury. Prehosp Emerg Care 2005;9:119.
  12. Sporer KA, Youngblood GM, Rodriguez RM. The ability of emergency medical dispatch codes of medical complaints to predict ALS prehospital interventions. Prehosp Emerg Care 2007;11:192-8.
  13. Clawson J, Olola C, Heward A, Patterson B, Scott G. The medical priority dispatch system's ability to predict cardiac arrest outcomes and high acuity pre-hospital alerts in chest pain patients presenting to 9-9-9. Resuscitation 2008;78:298-306.
  14. Neely KW, Eldurkar JA, Drake ME. Do emergency medical services dispatch nature and severity codes agree with paramedic field findings? Acad Emerg Med 2000;7:174-80.
  15. Heward A, Damiani M, Hartley-Sharpe C. Does the use of the advanced medical priority dispatch system affect cardiac arrest detection? Emerg Med J 2004;21:115-8.
  16. Merchant RM, Kurz MM, Gupta R. Identification of cardiac arrest by emergency dispatch. Acad Emerg Med 2005;12:457.
  17. Fullerton JN, Price CL, Silvey NE, Brace SJ, Perkins GD. Is the Modified Early Warning Score (MEWS) superior to clinician judgement in detecting critical illness in the pre-hospital environment? Resuscitation 2012;83:557-62.
  18. Mulholland SA, Gabbe BJ, Cameron P. Victorian State Trauma Outcomes Registry and Monitoring Group (VSTORM). Is paramedic judgement useful in prehospital trauma triage? Injury 2005;36:1298-305.
  19. Brown LH, Hubble MW, Cone DC, Millin MG, Schwartz B, Patterson PD, et al. Paramedic determinations of medical necessity: A meta-analysis. Prehosp Emerg Care 2009;13:516-27.
  20. Hajbagheri MA, Parvizi S, Salsali M. Qualitative Research Method. 3rd ed.. Tehran: Boshra Publishing; 2013.
  21. Geoffrey RN, David LS. Biostatistics. 2nd ed.. London: Hamilton; 2002.
  22. Lawshe CH. A quantitative approach to content validity. Pers Psychol 1975;28:563-75.
  23. LoBiondo-Wood G, Hober J. Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. 8th ed.. St. Louis: Mosby, Elsevier; 2014.
  24. Jearwattanakanok K, Yamada S, Suntornlimsiri W, Smuthtai W, Patumanond J. Clinical scoring for diagnosis of acute lower abdominal pain in female of reproductive age. Emerg Med Int 2013;2013:730167.
  25. Feldmann U, Steudel I. Methods of ordinal classification applied to medical scoring systems. Stat Med 2000;19:575-86.
  26. Ebrahimian A, Seyedin H, Jamshidi-Orak R, Masoumi G. Exploring factors affecting emergency medical services staffs' decision about transporting medical patients to medical facilities. Emerg Med Int 2014;2014:215329.
  27. Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Brunner and Suddarths Textbook of Medical-Surgical Nursing. 13th ed.. New York: Lippincott Williams and Wilkins; 2014.
  28. Seymour CW, Kahn JM, Cooke CR, Watkins TR, Heckbert SR, Rea TD. Prediction of critical illness during out-of-hospital emergency care. JAMA 2010;304:747-54.
  29. Suriya C, Kasatpibal N, Kunaviktikul W, Kayee T. Development of a simplified diagnostic indicators scoring system and validation for peptic ulcer perforation in a developing country. Clin Exp Gastroenterol 2012;5:187-94.
  30. Frost PJ, Wise MP. Early management of acutely ill ward patients. BMJ 2012;345:e5677.
  31. Barbara KT, Nancy ES. Introductory Medical-Surgical Nursing. 11th ed. New York: Lippincott Williams & Wilkins; 2014.
  32. Bulut M, Cebicci H, Sigirli D, Sak A, Durmus O, Top AA, et al. The comparison of modified early warning score with Rapid Emergency Medicine Score: A prospective multicentre observational cohort study on medical and surgical patients presenting to emergency department. Emerg Med J 2014;31:476-81.
  33. Stiell IG, Clement CM, Brison RJ, Rowe BH, Borgundvaag B, Aaron SD, et al. A risk scoring system to identify emergency department patients with heart failure at high risk for serious adverse events. Acad Emerg Med 2013;20:17-26.
  34. Jo S, Lee JB, Jin YH, Jeong TO, Yoon JC, Jun YK, et al. Modified early warning score with rapid lactate level in critically ill medical patients: The ViEWS-L score. Emerg Med J 2013;30:123-9.
  35. Cattermole GN, Liow EC, Graham CA, Rainer TH. THERM: The resuscitation management score. A prognostic tool to identify critically ill patients in the emergency department. Emerg Med J 2014;31:803-7.
  36. Duckitt RW, Buxton-Thomas R, Walker J, Cheek E, Bewick V, Venn R, et al. Worthing physiological scoring system: Derivation and validation of a physiological early-warning system for medical admissions. An observational, population-based single-centre study. Br J Anaesth 2007;98:769-74.
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