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New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients

Department of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, 40133 Bologna, Italy
Endocrinology Unit, Maggiore-Bellaria Hospital, 3-40139 Bologna, Italy
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy
Department of Medical and Surgical Sciences, Alma Mater Studiorum University, 40126 Bologna, Italy
Institute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
Department of Pathophysiology and Transplantation, University of Milan, 00168 Milan, Italy
Department of Anesthesiology, Intensive Care and Emergency, Fondazione IRCCS Ca’ GrandaOspedale Maggiore Policlinico, 20122 Milan, Italy
Clinical Governance and Quality Unit, Bologna Local Healthcare Authority Staff, 40133 Bologna, Italy
Author to whom correspondence should be addressed.
Academic Editor: Marcello Covino
J. Clin. Med. 2021, 10(12), 2617;
Received: 4 April 2021 / Revised: 8 June 2021 / Accepted: 9 June 2021 / Published: 14 June 2021
Background: The National Early Warning Score (NEWS) is an assessment scale of in-hospital patients’ conditions. The purpose of this study was to assess the appropriateness of a potential off-label use of NEWS by the emergency medical system (EMS) to facilitate the identification of critical patients and to trigger appropriate care in the pre-hospital setting. Methods: A single centre, longitudinal, prospective study was carried out between July and August 2020 in the EMS service of Bologna. Home patients with age ≥ 18 years old were included in the study. The exclusion criterion was the impossibility to collect all the parameters needed to measure NEWS. Results: A total of 654 patients were enrolled in the study. The recorded NEWS values increased along with the severity of dispatch priority code, the EMS return code, the emergency department triage code, and with patients’ age (r = 0.135; p = 0.001). The aggregated value of NEWS was associated with an increased risk of hospitalization (OR = 1.30 (1.17; 1.34); p < 0.0001). Conclusion: This study showed that the use of NEWS in the urgent and emergency care services can help patient assessment while not affecting EMS crew operation and might assist decision making in terms of severity-code assignment and resources utilization. View Full-Text
Keywords: cardiac arrest; EMS; National Early Warning Score; NEWS; ambulance; apps; out-of-hospital cardiac arrest; EMS; National Early Warning Score; NEWS; ambulance; apps; out-of-hospital
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MDPI and ACS Style

Semeraro, F.; Corona, G.; Scquizzato, T.; Gamberini, L.; Valentini, A.; Tartaglione, M.; Scapigliati, A.; Ristagno, G.; Martella, C.; Descovich, C.; Picoco, C.; Gordini, G. New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients. J. Clin. Med. 2021, 10, 2617.

AMA Style

Semeraro F, Corona G, Scquizzato T, Gamberini L, Valentini A, Tartaglione M, Scapigliati A, Ristagno G, Martella C, Descovich C, Picoco C, Gordini G. New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients. Journal of Clinical Medicine. 2021; 10(12):2617.

Chicago/Turabian Style

Semeraro, Federico, Giovanni Corona, Tommaso Scquizzato, Lorenzo Gamberini, Anna Valentini, Marco Tartaglione, Andrea Scapigliati, Giuseppe Ristagno, Carmela Martella, Carlo Descovich, Cosimo Picoco, and Giovanni Gordini. 2021. "New Early Warning Score: EMS Off-Label Use in Out-of-Hospital Patients" Journal of Clinical Medicine 10, no. 12: 2617.

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