- Walter Renier
- Frank Buntinx
During emergencies, general practitioners (GP) make decisions based on history taking, signs and symptoms, using simple devices. We hypothesize that the diagnostic accuracy can be improved by technological diagnostic and monitoring devices and by point of care tests (POCT). The objectives are to improve GP-related steps in the chain of medical assistance for patients in emergencies by improving the diagnostic approach and referral decisions by diminishing false positive referrals. Better monitoring and transfer of the accumulated information to the next steps in the chain will enhance information to the incoming EMS physician and patient outcome. The monitoring device has to measure preferentially the pulse (in bpm), the oxygen saturation (measured by pulse oximetry as SpO2), the respiratory rate (in cycles/min), the blood pressure (in mm Hg, systolic and diastolic), body temperature (in °C) and ECG (preferentially 12-lead ECG). In Phase I we will conduct an accuracy study for device validation, secondly a preliminary study by using the device in emergency situations in own settings in order to discover advantages and shortenings and, thirdly, a preliminary study “in vitro” by observing the use the device in simulated situations with the SIimMan3G manikin. In phase II we will conduct a pilot study in “vivo” where, after retraining in emergencies, some GP’s will observe the use of the device in real situations: what is the impact of the device on decision making and monitoring and is the information transferred to the emergency physicians helpful? Based on these findings and corrections, we finally will conduct in phase III a field study to observe if the monitoring device does enhance decision making and better outcome of acute ill patients in comparison to a group without a monitoring device. The long term target of these studies is to develop models for association between the parameters and to formulate proposals and guidelines for GPs in emergency situations.