Effectiveness of Advanced Paramedics in a Mobile Coronary Care System

Lewis, Richard P.

doi:10.1001/jama.1979.03290440024021

Cited by 68 publications

(5 citation statements)

References 7 publications

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“…Although some studies have documented higher survival rates after cardiac arrest in EMS systems that include experienced physicians, [225][226][227][228][229][230][231][232] compared with those that rely on non-physician providers, 225,226,233,234 some other comparisons have found no difference in survival between systems using paramedics or physicians as part of the response. [235][236][237] Well-organised non-physician systems with highly trained paramedics have also reported high survival rates. 238 Given the inconsistent evidence, the inclusion or exclusion of physicians among prehospital personnel responding to cardiac arrests will depend largely on existing local policy.…”

Section: Ems Personnel and Interventionsmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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These Guidelines are based on the International Liaison Committee on Resuscitation (ILCOR) 2015 Consensus on Science and Treatment Recommendations (CoSTR) for ALS. 4 The 2015 ILCOR review focused on 42 topics organised in the approximate sequence of ALS interventions: defibrillation, airway, oxygenation and ventilation, circulatory support, monitoring during CPR, and drugs during CPR. For these Guidelines the ILCOR recommendations were supplemented by focused literature reviews undertaken by the ERC ALS Writing Group for those topics not reviewed in the 2015 ILCOR CoSTR. Guidelines were drafted and agreed by the ALS Writing Group members before final approval by the ERC General Assembly and ERC Board. Summary of changes since 2010 GuidelinesThe 2015 ERC ALS Guidelines have a change in emphasis aimed at improved care and implementation of these guidelines in order to improve patient focused outcomes. 5 The 2015 ERC ALS Guidelines do not include any major changes in core ALS interventions since the previous ERC guidelines published in 2010. 1,2 The key changes since 2010 are:• Continuing emphasis on the use of rapid response systems for care of the deteriorating patient and prevention of in-hospital cardiac arrest. • Continued emphasis on minimally interrupted high-quality chest compressions throughout any ALS intervention: chest

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Section: Ems Personnel and Interventionsmentioning

confidence: 99%

European Resuscitation Council Guidelines for Resuscitation 2015

et al. 2015

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“…Ideally, to identify the extent to which the urban/ rural differential observed in injury death rates is due to differences in availability of medical care in urban versus rural areas, measurement would be made directly at the individual level, and for prehospital and hospital factors that affect the probability of surviving following an injury. Prehospital factors, such as the time it takes the emergency medical system to respond to a call, and the level of training of rescue team members appear to make a difference in patient survival (Lewis, Stang, Fulkerson, Sampson, Scoles, & Warren, 1979;Mayer, 1979aMayer, , 1979bPilcher, Gettinger, & Seligson, 1979). influence patient outcome, affecting chances of .…”

mentioning

confidence: 99%

Inequities in Health Care and Survival After Injury Among Pedestrians: Explaining the Urban/Rural Differential

Miles-Doan

Kelly²

1995

The Journal of Rural Health

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This study investigated whether rural/urban differences in injury mortality and morbidity are primarily due to medical care maldistribution or to other factors such as sociodemographic or environmental characteristics that are highly correlated with location. To separate incidence from case-fatality rates, the study analyzed the determinants of survival rather than cause-specific mortality rates. Using information from Florida traffic crash reports for 1988 through 1990, the study focused on Florida pedestrians hit by motor vehicles. It explores the effect of individual-level demographic characteristics, crash-level indicators of impact severity, and county-level measures of socioeconomic and medical care resources, on the odds a pedestrian survived an injury. Logistic regression analyses reveal the importance of both road environment and percent of the county that is rural. However, these analyses are not able to isolate the influence of medical care from the level of urbanization. Although the percent rural was statistically significant, indicators of the mechanical energy involved in producing the injury, posted speed, and a dark road environment were substantively more important determinants of survival.

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“…This requires specific training in advanced life support (i.e., arrhythmias). Most important though is immediate intervention by the lay public which requires extensive training (1,5,7,8,11,19,24,27,28,32,33,35). The cautious attitude currently prevalent in the lay public towards Most emergencies occurred during the day time.…”

Section: Type Of Emerqency_by the Two Major Age Groupsmentioning

confidence: 99%

“…Length of hospital stay for all survivors and time of death of non-survivors lay public which requires extensive training(1,5,7,8,11,19,24,27,28,32,33,35). The cautious attitude currently prevalent in the lay public towards Assessment of need for call in relation to the level of consciousness emergencies should be discouraged and active intervention emphasized.…”

mentioning

confidence: 99%

Interdisciplinary Emergency Care System in a Medium Sized City: Evaluation of 3,997 Cases Over a Four Year Period

Behrenbeck

Fastenrath

Behrenbeck

et al. 1986

Prehosp. Disaster med.

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In 1978 an emergency medical system was established to provide extensive, on the spot treatment for medical emergencies and traffic accidents in Miinster. It was designed, like other systems (17,21,23,25,31,34) to treat all types of medical emergencies, although it was initially thought that victims of traffic accidents would predominate. The system covers the city of Miinster, which is the capital of Westphalia (see Figure 1) and has a population of 270,000 plus its neighboring communities. Thus, the service provides for 300,000 people over a 20 mile circle in diameter. This area has a low percentage of blue collar workers due to a lack of industry, as Miinster is mainly an academic, administrative and business center.A rendezvous system was created where a physician and a specially trained driver/emergency technician (ET) are met at the site of the emergency by two other emergency technicians with a fully equipped ambulance (according to the national German standard DIN 75080 for advanced life support systems). The technical staff and equipment is provided by the local fire brigade. It is here where the emergency calls are received and the alarm is initiated. A triage type questionnaire (Figure 2) helps to define the nature of the emergency and whether an alarm is actually necessary. Three departments of the University Hospital (internal medicine and surgery together with anesthesiology) alternate in the daily 24 hour provision of the physician and the technicians work on a 24 hour shift basis. An evaluation sheet is completed after every run which includes information of the degree of consciousness, respiratory, cardiovascular and physical status, type of emergency, therapeutic measures, final results etc. (Figure 3).For this study all cases (n=3997) from 1980-83 were evaluated using SPSSX (Statistical Package for

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Effectiveness of Advanced Paramedics in a Mobile Coronary Care System

Cited by 68 publications

References 7 publications

European Resuscitation Council Guidelines for Resuscitation 2015

European Resuscitation Council Guidelines for Resuscitation 2015

Inequities in Health Care and Survival After Injury Among Pedestrians: Explaining the Urban/Rural Differential

Interdisciplinary Emergency Care System in a Medium Sized City: Evaluation of 3,997 Cases Over a Four Year Period

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