Accuracy of early shock recognition by paramedics: a multicenter prospective observational study in Japan.

OBJECTIVE

Early recognition of shock status by paramedics significantly affects patient prognosis; however, its accuracy remains unclear. This study assessed the diagnostic accuracy of paramedics in classifying shock and the characteristics of misdiagnoses.

MATERIALS AND

METHODS

This multicenter prospective observational study compared the on-scene shock diagnoses of paramedics between July 2022 and June 2023 with those of physicians upon hospital arrival.

RESULTS

The overall diagnostic accuracy for shock revealed substantial agreement (k=0.64), whereas diagnosis by category ranged from slight to moderate agreement (k=0.11-0.51). Patients without systolic hypotension were more frequently missed during diagnosis.

CONCLUSIONS

Enhanced clinical education is needed to improve the accuracy of shock diagnosis by paramedics.