title: Pre-hospital assessment by a single responder: The Swedish ambulance nurse in a new role: A pilot study.
abstract: When a person with vague symptoms calls 112, the dispatchers often have difficulty prioritising the severity of the call. Their only alternative has been to send an ambulance. In Gothenburg, Sweden, a nurse-manned single responder (SR) was initiated to assess this patient group. The study aims to describe patient characteristics and assessment level made by the SR nurse among patients assessed by the dispatcher as low priority and/or vague symptoms. A consecutive journal review was conducted. During six months, 529 patients were assessed; 329 (62%) attended the emergency department (ED) or inpatient care (IC). Of these, 85 patients (26%) were assessed as high priority. Only 108 were assessed as being in need of ambulance transport. ED/IC patients were significantly older. Two hundred (38%) stayed at the scene (SS) (n = 142) or were referred to primary care (PC) (n = 58). Of the 200 SS/PC patients, 38 (19%) attended the ED within 72 hrs with residual symptoms, 20 of whom were admitted to a ward. Nine patients (4% of 200 SS/PC patients) required inpatient treatment and 11 patients stayed overnight for observation. These results suggest a relatively high level of patient safety and the usefulness of an SR among patients assessed by the dispatcher as low priority.
authors.affiliation: Ambulance and Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: cw.magnusson@gmail.com.
authors.forename: Carl
authors.initials: C
authors.lastname: Magnusson
authors.affiliation: Kungälv Ambulance Service, Kungälv, Sweden.
authors.forename: Christofer
authors.initials: C
authors.lastname: Källenius
authors.affiliation: Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Knutsson
authors.affiliation: Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.affiliation: Ambulance and Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden; Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Axelsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009726:Nurses / Q000592:standards*; D009730:Nursing Assessment / Q000379:methods / Q000592:standards*; D010865:Pilot Projects; D012189:Retrospective Studies; D013548:Sweden; D000078329:Workforce
keywords: Ambulance nurse; Assessment; Emergency medical dispatcher; Pre-hospital care; Single responder; Triage