Classifying symptoms of traumatic spinal cord injury by emergency medical services, a feasibility study
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Rationale: A new instrument for emergency medical services has been developed to detect symptoms of spinal cord injury and enables patients to receive appropriate care earlier. As well, it makes research possible on the effectiveness of spinal immobilization. With the implementation of the Neurologic Evolution Classification (NEC), the opportunity arises to describe barriers and facilitators of the implementation for the first time in the Dutch emergency medical services. Objective: The feasibility study explores whether emergency medical services staff is capable of using the NEC to detect symptoms of spinal cord injury. Furthermore, to gain insight into the barriers and facilitators of implementation and usability of the NEC, used by Dutch emergency medical services. Methods A mixed methods study which was conducted in April and May 2013. With telephone interviews, an online survey and patient chart review, we assessed how emergency medical services staff experienced the NEC and determined implementation factors. The population consisted of registered nurses and patients that were suspected of spinal injury in the region of Nijmegen and Arnhem, in the Netherlands. Results Although adjustments are needed, the paramedics found the NEC useful, fast and applicable to multiple types of patients. The NEC is used by 16 of all 160 ambulance nurses. The barriers of implementation were collaboration with emergency department staffs and simultaneous studies in an organization. Motivation of the registered nurses and a multi-faceted implementation strategy with live training, are facilitating factors for implementation. Conclusion Detecting symptoms of spinal cord injury is feasible for emergency medical staff. The next step is to adjust and validate the NEC for national wide use. Burden/risk Approval of Medical Research Ethics Committee was not required.