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

• Published in: Journal of Rural Medicine Vol. 20; no. 2; pp. 125 - 131
• Main Authors: Tanohata, Rina, Nagano, Takehiko, Saito, Katsutoshi, Ochiai, Hidenobu
• Format: Journal Article
• Language: English
• Published: Japan THE JAPANESE ASSOCIATION OF RURAL MEDICINE 2025; The Japanese Association of Rural Medicine
• Subjects: clinical education; emergency medical services; Original; paramedics; shock diagnosis; emergency medical services; shock diagnosis; clinical education; paramedics
• ISSN: 1880-487X; 1880-4888
• DOI: 10.2185/jrm.2024-053

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.