PMID- 30678636
OWN - NLM
STAT- MEDLINE
DCOM- 20190612
LR  - 20200309
IS  - 1471-227X (Electronic)
IS  - 1471-227X (Linking)
VI  - 19
IP  - 1
DP  - 2019 Jan 24
TI  - Adverse events in prehospital emergency care: a trigger tool study.
PG  - 14
LID - 10.1186/s12873-019-0228-3 [doi]
LID - 14
AB  - BACKGROUND: Prehospital emergency care has developed rapidly during the past 
      decades. The care is given in a complex context which makes prehospital care a 
      potential high-risk activity when it comes to patient safety. Patient safety in 
      the prehospital setting has been only sparsely investigated. The aims of the 
      present study were 1) To investigate the incidence of adverse events (AEs) in 
      prehospital care and 2) To investigate the factors contributing to AEs in 
      prehospital care. METHODS: We used a retrospective study design where 30 randomly 
      selected prehospital medical records were screened for AEs each month in three 
      prehospital organizations in Sweden during a period of one year. A total of 1080 
      prehospital medical records were included. The record review was based on the use 
      of 11 screening criteria. RESULTS: The reviewers identified 46 AEs in 46 of 1080 
      (4.3%) prehospital medical records. Of the 46 AEs, 43 were classified as 
      potential for harm (AE1) (4.0, 95% CI = 2.9-5.4) and three as harm identified 
      (AE2) (0.3, 95% CI = 0.1-0.9). However, among patients with a life-threatening 
      condition (priority 1), the risk of AE was higher (16.5%). The most common 
      factors contributing to AEs were deviations from standard of care and missing, 
      incomplete, or unclear documentation. The most common cause of AEs was the result 
      of action(s) or inaction(s) by the emergency medical service (EMS) crew. 
      CONCLUSIONS: There were 4.3 AEs per 100 ambulance missions in Swedish prehospital 
      care. The majority of AEs originated from deviations from standard of care and 
      incomplete documentation. There was an increase in the risk of AE among patients 
      who the EMS team assessed as having a life-threatening condition. Most AEs were 
      possible to avoid.
FAU - Hagiwara, Magnus Andersson
AU  - Hagiwara MA
AUID- ORCID: 0000-0002-6888-9323
AD  - Faculty of Caring Science, Work Life and Social Welfare, University of Boras, 
      SE-501 90, Boras, Sweden. magnus.hagiwara@hb.se.
FAU - Magnusson, Carl
AU  - Magnusson C
AD  - Department of Molecular and Clinical Medicine, University of Gothenburg and 
      Sahlgrenska University Hospital, SE-405 30, Gothenburg, Sweden.
FAU - Herlitz, Johan
AU  - Herlitz J
AD  - Faculty of Caring Science, Work Life and Social Welfare, University of Boras, 
      SE-501 90, Boras, Sweden.
FAU - Seffel, Elin
AU  - Seffel E
AD  - Department of Ambulance Care, Sodra Alvsborg Hospital (SAS), SE-501 82, Boras, 
      Sweden.
FAU - Axelsson, Christer
AU  - Axelsson C
AD  - Faculty of Caring Science, Work Life and Social Welfare, University of Boras, 
      SE-501 90, Boras, Sweden.
FAU - Munters, Monica
AU  - Munters M
AD  - Department of Ambulance Care, Region of Dalarna, SE-791 29, Falun, Sweden.
FAU - Stromsoe, Anneli
AU  - Stromsoe A
AD  - School of Health, Care and Social Welfare, Malardalens hogskola, SE-721 23, 
      Vasteras, Sweden.
FAU - Nilsson, Lena
AU  - Nilsson L
AD  - Department of Anaesthesiology and Intensive Care and Department of Medical and 
      Health Sciences, Linkoping University, SE-581 85, Linkoping, Sweden.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190124
PL  - England
TA  - BMC Emerg Med
JT  - BMC emergency medicine
JID - 100968543
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Emergency Medical Services/standards/*statistics & numerical data
MH  - Emergency Treatment/*adverse effects/standards
MH  - Equipment Failure
MH  - Female
MH  - Humans
MH  - Male
MH  - Medical Errors/*adverse effects
MH  - Middle Aged
MH  - Patient Safety
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC6345067
OTO - NOTNLM
OT  - Adverse events
OT  - Emergency medical service
OT  - Patient safety
OT  - Prehospital
OT  - Trigger tool
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study was approved by the 
      Regional Ethics Committee, Gothenburg, Sweden (Dnr: 047-15). CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they 
      have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2019/01/27 06:00
MHDA- 2019/06/14 06:00
PMCR- 2019/01/24
CRDT- 2019/01/26 06:00
PHST- 2018/08/14 00:00 [received]
PHST- 2019/01/15 00:00 [accepted]
PHST- 2019/01/26 06:00 [entrez]
PHST- 2019/01/27 06:00 [pubmed]
PHST- 2019/06/14 06:00 [medline]
PHST- 2019/01/24 00:00 [pmc-release]
AID - 10.1186/s12873-019-0228-3 [pii]
AID - 228 [pii]
AID - 10.1186/s12873-019-0228-3 [doi]
PST - epublish
SO  - BMC Emerg Med. 2019 Jan 24;19(1):14. doi: 10.1186/s12873-019-0228-3.