Articles: emergency-medical-services.
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During the Heartstart Scotland project all 407 ambulances in Scotland were equipped with automated external defibrillators (AEDs). All cases of chest pain or collapse aged over 10 years were monitored and multiple 3-s rhythm strips recorded in a solid state memory module. A shockable rhythm was defined as an organised rhythm of > or = 180 beats/min or a disorganised rhythm of > or = 100 beats/min and amplitude > 0.1 mV. ⋯ However, only 66 of the 120 false negatives were attributable to the AED giving a sensitivity of 90.3% for the AED. The sensitivity of the AED is dependent on the prevalence of shockable rhythms, but will be within the range 90.3-94.4% for most emergency medical services. We conclude that early management of potentially lethal arrhythmias by ambulance technicians using AEDs is practical with acceptable sensitivity and specificity.
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All EMS providers must work for an ambulance company, right? Wrong. There are many avenues open to EMTs and paramedics that even those involved in EMS don't know about. Take a look at three providers with unique jobs: They help provide medical care for the president and vice president of the United States.
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Flora's Z statistic and standardized mortality ratios (SMRs) as indicators of excess mortality were calculated for a sample of 355 patients with major trauma. A statistically significant overall excess mortality was observed in this sample (Z = 6.77, SMR = 1.81, p less than 0.05). ⋯ Total prehospital time over 60 minutes was associated with a significant increase in excess mortality (p less than 0.001). These results support regionalization of trauma care and failed to show any benefit associated with MD-ALS.
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QA activities in EMS systems are severely hampered unless a central agency exists to coordinate data collection, funding, and communication between agencies and field providers. EMS systems must address these issues successfully to maximize their efforts. Some regions (San Francisco, King County, Washington, Burbank, California) have developed dedicated organizations for the evaluation of prehospital care. ⋯ One survey found an improved sense of teamwork after initiating these programs. Patients must receive quality emergency medical care from the moment they enter the health care system. Leadership by the medical community is crucial if this goal is to be realized.