How accurate is the prehospital diagnosis of hyperventilation syndrome?
Wilson, Caitlin
Harley, Clare Steels, Stephanie
Harley, Clare
Steels, Stephanie
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Abstract
Background:
The literature suggests that hyperventilation syndrome (HVS) should be diagnosed and treated prehospitally.
Aim:
To determine diagnostic accuracy of HVS by paramedics and emergency medical technicians using hospital doctors' diagnosis as the reference standard.
Methods:
A retrospective audit was carried out of routine data using linked prehospital and in-hospital patient records of adult patients (≥18 years) transported via emergency ambulance to two emergency departments in the UK from 1 January 2012–31 December 2013. Accuracy was measured using sensitivity, specificity, positive and negative predictive values (NPV/PPVs) and likelihood ratios (LRs) with 95% confidence intervals.
Results:
A total of 19 386 records were included in the analysis. Prehospital clinicians had a sensitivity of 88% (95% CI [82–92%]) and a specificity of 99% (95% CI [99–99%]) for diagnosing HVS, with PPV 0.42 (0.37, 0.47), NPV 1.00 (1.00, 1.00), LR+ 75.2 (65.3, 86.5) and LR− 0.12 (0.08, 0.18).
Conclusions:
Paramedics and emergency medical technicians are able to diagnose HVS prehospitally with almost perfect specificity and good sensitivity.
Abstract published with permission.