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【論文摘要】COVID-19 and Paramedic Response: Overcategorization Concerns in Respiratory Patients


Background: The COVID-19 pandemic has had a profound impact on healthcare systems around the world, particularly those working on the frontline. Among these are paramedics, who have faced unique challenges in responding to the crisis. One such challenge is the categorization of all patients with respiratory symptoms as potential COVID-19 cases. Respiratory issues are particularly prone to misdiagnosis due to the diverse range of possible causes, including Chronic Obstructive Pulmonary Disease (COPD), Congestive Heart Failure (CHF), trauma, or allergic reactions, each requiring different treatments. Overcategorizing patients with respiratory symptoms as having COVID-19 may lead to neglecting or overlooking these other possible diagnoses, potentially resulting in inappropriate treatment and poorer patient outcomes. Methods: Ten paramedics who had over 4 years experience were recruited from across the United States to participate in a recorded qualitative interview about their experiences. The question was asked about respiratory patients, “How were respiratory patients treated any different before COVID 19 versus during the pandemic?” The responses were coded for themes that would allow for analysis. Results: The majority of paramedic participants showed concern for the problem with overcategorizing patients as all having COVID 19, even those who likely did not. They acknowledged the necessity of being cautious given the risks posed by the pandemic, but also worried about the potential harm caused by overcategorization. Due to the highly infectious nature of COVID-19, paramedics have been wary of using assessment tools that require close proximity to patients, such as stethoscopes. Additionally, treatments like nebulized therapies that necessitate confined spaces and potentially contaminate the air have also been avoided for fear of infection. Conclusions: As we continue to navigate through and beyond the COVID-19 pandemic, it is crucial to learn from these experiences that show concern for overcategorization. While caution is necessary to prevent the spread of COVID-19, it's equally important to ensure that patients with other conditions receive appropriate care. Balancing these needs will be key in future healthcare crises and in the ongoing evolution of emergency medical services.