title: Effects of a standard operating procedure on prehospital emergency care of patients presenting with symptoms of the acute coronary syndrome.
abstract: To determine whether a standard operating procedure (SOP) for prehospital management of patients with the acute coronary syndrome (ACS) improves the quality of patient care in terms of adherence to treatment guidelines of the European Society of Cardiology. Among a total of 1025 patient medical records collected from a period before and after the introduction of the SOP, 269 records included the working diagnosis of ACS and were then reviewed for guideline adherence. Most aspects of patient evaluation, monitoring, treatment, and hospital allocation were fairly guideline adherent (>70%) before the SOP was introduced and were not affected by the SOP. The percentage of cases in whom sublingual nitrate (55.2 vs. 66.7%) or intravenous morphine (26.9 vs. 43.0%) was administered without contraindications was higher after the SOP had been introduced. Therefore, the use of an SOP in prehospital emergency medicine can partly improve the adherence to guideline recommendations for the treatment of patients with ACS.
authors: aDepartment of Anesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin bDepartment of Emergency Medicine, Bundeswehrkrankenhaus Berlin, Berlin cDepartment of Anesthesiology and Intensive Care Medicine, Asklepios Klinik Harburg, Hamburg, Germany.
authors: Roland C
authors: RC
authors: Francis
authors: Florian
authors: F
authors: Bubser
authors: Willi
authors: W
authors: Schmidbauer
authors: Claudia D
authors: CD
authors: Spies
authors: Marc
authors: M
authors: Sörensen
authors: Götz
authors: G
authors: Bosse
authors: Thoralf
authors: T
authors: Kerner
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D019468:Disease Management; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D005996:Nitroglycerin / Q000008:administration & dosage; D017410:Practice Guidelines as Topic / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009020:Morphine; D005996:Nitroglycerin