Management and documentation of pneumonia – a comparison of patients consulting primary care and emergency care

• Published in: Scandinavian journal of primary health care Vol. 42; no. 2; pp. 338 - 346
• Main Authors: Arntsberg, Louise, Fernberg, Sara, Berger, Ann-Sofie, Hedin, Katarina, Moberg, Anna
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis LLC 2024; Taylor & Francis; Taylor & Francis Group
• Subjects: Anestesi och intensivvård; Anesthesiology and Intensive Care; Blood pressure; Chest; Clinical Medicine; Documentation; emergency care; Emergency medical care; Emergency services; Heart rate; High risk; Infections; Klinisk medicin; Medical and Health Sciences; Medical referrals; Medicin och hälsovetenskap; Oxygen; Oxygen saturation; Patients; Pneumonia; Primary care; Saturation; Severity; severity scoring; Vital signs; primary care; Pneumonia; vital signs; emergency care; severity scoring
• ISSN: 0281-3432; 1502-7724; 1502-7724
• DOI: 10.1080/02813432.2024.2326469

To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Medical record review of vital signs, examination findings and severity of pneumonia. Primary and emergency care. Two hundred and forty patients diagnosed with pneumonia. Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (  < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (  < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent.