CHEST PAIN AS THE LEADING SYMPTOM OF THE EMERGENCY CALL IN THE MEDICAL REGISTRATION ALERT UNIT OF THE EMERGENCY

SAŽETAK Uvod: Bol u prsima jedan je od najčešćih simptoma, može se pojaviti iznenada, na različitim mjestima, različitog je intenziteta i karakteristika, patologija se kreće od bezopasnih do hitnih stanja opasnih po život. Često izaziva potrebu za pozivanjem i interveniranjem hitne medicinske službe. Cilj: Cilj ovog rada je analizirati distribuciju hitnih poziva u Medicinsko prijavno dojavnoj jedinici Zavoda za hitnu medicinu Zagrebačke županije prema dispečerskoj kartici 09 „bol u prsima/srčane bolesti“ Hrvatskog indeksa prijema hitnog poziva. Metode: Retrospektivno se analizira 37 819 hitnih poziva koji su zaprimljeni u informacijsko komunikacijskom sustavu „e-hitne“ Zavoda za hitnu medicinu Zagrebačke županije u vremenskom periodu od 01.06.2021. do 31.12.2021. na području Zagrebačke županije. Analizira se učestalost odabira dispečerske kartici 09 „Bol u prsima/srčane bolesti” prema HIPHP. Za pozive procijenjene dispečerskom karticom 09 „Bol u prsima/srčane bolesti“ HIPHP analizira se pojavnost boli u prsima prema dobi, spolu, vremenu poziva, prioritetu. Rezultati: Ukupno je u sustavu „e – hitne“ zabilježeno 37 819 poziva od 01.06.2021. do 31.12.2021. na području Zagrebačke županije. Dobivenim rezultatima utvrdili smo kako se od ukupnog broja zaprimljenih poziva njih 45% (16 918) odnosi na hitne intervencije. Intervencija I. prioriteta(A) zabilježeno je 32% (5360). Od ukupno svih procijenjenih hitnih poziva na dispečersku karticu 09 „bol u prsima/srčane bolesti“ odnosi se 9, 47% (1597). Medicinski dispečer s obzirom na učestalost odabira dispečerske karticu 09 „bol u prsima/srčane bolesti“ odlučio se za I. prioritet (A) u 20% (1050), II. Prioritet (H) u 5% (532), te III. prioritet (V) u 1% (15) hitnih poziva. Prema spolu za dispečersku karticu 09 „bol u prsima/srčane bolesti“ u I. prioritetu (A) u 59, 04% (620) slučajeva odnosi se na muški spol. Prema stupnju procjene medicinskog dispečera je veći kod muškaraca (p=0,001). Prema životnoj dobi dispečerska kartica 09 „bol u prsima/srčane bolesti najviše se koristila za osobe u kategoriji starosti od 66 do 80 godina. Središnja vrijednost godina života iznosi 68 (±9 SD). Izbor prioriteta medicinskog dispečera je bio značajno povezan s dobi bolesnika (p=0,001). Najveća frekvencija poziva prema dobu dana dispečerska kartica 09 „bol u prsima/srčane bolesti“ bilježi se u vremenskom intervalu od 22:00 do 22:59. U vremenskom intervalu od 21:00 do 23:00 ima više poziva (p=0,009). Stupanj hitnosti je po prioritetu veći od strane medicinskog dispečera za I. prioritete (A) u odnosu na tim HMS (p=0,001). Zaključak: Visoka razina preciznosti medicinskog dispečera, te implementacija HIPHP u hitni poziv omogućava kategorijsku optimizaciju identifikacije pacijenata s boli u prsima čime osigurava pravodobni odgovora s odgovarajućim resursima. Nadziranjem, analiziranjem i vrednovanjem postojećih radnih procesa u MPDJ doprinosi se unapređenju zdravstvene skrbi, a time i zdravstvenog sustava.SUMMARY Introduction: Chest pain is one of the most common symptoms, it can appear suddenly, in different places, it is of different intensity and characteristics, the pathology ranges from harmless to life-threatening emergencies. It often causes the need to call and intervene in the emergency medical service. The aim: The aim of this paper is to analyze the distribution of emergency calls in the Medical Reporting Unit of the Zagreb County Institute of Emergency Medicine according to the dispatch card 09 „Chest pain / heart disease" of the Croatian Emergency Call Index. Methods: 37,819 emergency calls received in the information and communication system „e-hitna" of the Zagreb County Institute of Emergency Medicine in the period from 01.06.2021 are retrospectively analyzed. to 31.12.2021. in the Zagreb County. The frequency of selection of the dispatch card 09 „Chest pain / heart disease" according to HIPHP is analyzed. For calls assessed by the dispatch card 09 „Chest pain / heart disease" HIPHP analyzes the incidence of chest pain by age, sex, call time, priority. Results: A total of 37,819 calls were recorded in the e-emergency system as of June 1, 2021. To Decembar 31, 2021. in the Zagreb County. With the obtained results, we determined that 45% (16,918) of the total number of received calls were related to emergency interventions. Intervention I. priority (A) was recorded 32% (5360). Out of the total of all estimated emergency calls to the dispatch card 09 „chest pain / heart disease", 9.47% (1597). The medical dispatcher, considering the frequency of selecting the dispatch card 09 „Chest pain / heart disease", opted for I. priority (A) in 20% (1050), II. Priority (H) in 5% (532), and III. priority (V) in 1% (15) of emergency calls. According to gender for dispatch card 09 „chest pain / heart disease" in priority I (A) in 59.04% (620) cases refers to males. According to the assessment rate of the medical dispatcher, it is higher in men (p = 0.001). According to age, the dispatch card 09 „ chest pain / heart disease" was mostly used for people in the age category from 66 to 80 years. The median age was 68 (± 9 SD). The choice of medical dispatcher priority is significantly related to patient age (p = 0.001). The highest frequency of calls according to the time of day dispatch card 09 „chest pain / heart disease" is recorded in the time interval from 22:00 to 22:59. There are more calls in the time interval from 21:00 to 23:00 (p = 0.009). The degree of urgency is higher in priority by the medical dispatcher for I. priority (A) compared to the HMS team (p = 0.001). Conclusion: The high level of precision of the medical dispatcher, and the implementation of HIPHP in the emergency call allows categorical optimization of the identification of patients with chest pain, thus ensuring timely response with appropriate resources. By monitoring, analyzing and evaluating the existing work processes in the MPDJ, it contributes to the improvement of health care, and thus the health system