AIM: The aim of this prospective study was the comparison of four emergency medical service (EMS) systems-emergency physician (EP) and paramedic (PM) based-and the impact of advanced live support (ALS) on patients status in preclinical care. METHODS: The EMS systems of Bonn (GER, EP), Cantabria (ESP, EP), Coventry (UK, PM) and Richmond (US, PM) were analysed in relation to quality of structure, process and performance when first diagnosis on scene was cardiac arrest (OHCA), chest pain or dyspnoea. Data were collected prospectively between 01.01.2001 and 31.12.2004 for at least 12 month. RESULTS: Over all 6277 patients were included in this study. The rate of drug therapy was highest in the EP-based systems Bonn and Cantabria. Pain relief was more effective in Bonn in patients with severe chest pain. In the group of patients with chest pain and tachycardia ≥ 120 beats/min, the heart rate was reduced most effective by the EP-systems. In patients with dyspnoea and S(p)O(2) <90% the improvement of oxygen saturation was most effective in Bonn and Richmond. After OHCA significant more patients reached the hospital alive in EMS systems with EPs than in the paramedic staffed (Bonn = 35.6%, Cantabria = 30.1%; Coventry = 11.9%, Richmond = 9.2%). The introduction of a Load Distributing Band chest compression device in Richmond improved admittance rate after OHCA (21.7%) but did not reach the survival rate of the Bonn EMS system. CONCLUSIONS: Higher qualification and greater training and experience of ALS unit personnel increased survival after OHCA and improved patient's status with cardiac chest pain and respiratory failure.
AIM: The aim of this prospective study was the comparison of four emergency medical service (EMS) systems-emergency physician (EP) and paramedic (PM) based-and the impact of advanced live support (ALS) on patients status in preclinical care. METHODS: The EMS systems of Bonn (GER, EP), Cantabria (ESP, EP), Coventry (UK, PM) and Richmond (US, PM) were analysed in relation to quality of structure, process and performance when first diagnosis on scene was cardiac arrest (OHCA), chest pain or dyspnoea. Data were collected prospectively between 01.01.2001 and 31.12.2004 for at least 12 month. RESULTS: Over all 6277 patients were included in this study. The rate of drug therapy was highest in the EP-based systems Bonn and Cantabria. Pain relief was more effective in Bonn in patients with severe chest pain. In the group of patients with chest pain and tachycardia ≥ 120 beats/min, the heart rate was reduced most effective by the EP-systems. In patients with dyspnoea and S(p)O(2) <90% the improvement of oxygen saturation was most effective in Bonn and Richmond. After OHCA significant more patients reached the hospital alive in EMS systems with EPs than in the paramedic staffed (Bonn = 35.6%, Cantabria = 30.1%; Coventry = 11.9%, Richmond = 9.2%). The introduction of a Load Distributing Band chest compression device in Richmond improved admittance rate after OHCA (21.7%) but did not reach the survival rate of the Bonn EMS system. CONCLUSIONS: Higher qualification and greater training and experience of ALS unit personnel increased survival after OHCA and improved patient's status with cardiac chest pain and respiratory failure.
Authors: André Dankert; Jochen Kraxner; Philipp Breitfeld; Clemens Bopp; Malte Issleib; Christoph Doehn; Janina Bathe; Linda Krause; Christian Zöllner; Martin Petzoldt Journal: J Clin Med Date: 2022-06-17 Impact factor: 4.964
Authors: Jörg C Brokmann; Rolf Rossaint; Michael Müller; Christina Fitzner; Luigi Villa; Stefan K Beckers; Sebastian Bergrath Journal: J Clin Hypertens (Greenwich) Date: 2017-05-30 Impact factor: 3.738
Authors: Jürgen Neukamm; Jan-Thorsten Gräsner; Jens-Christian Schewe; Martin Breil; Jan Bahr; Ulrich Heister; Jan Wnent; Andreas Bohn; Gilbert Heller; Bernd Strickmann; Hans Fischer; Clemens Kill; Martin Messelken; Berthold Bein; Roman Lukas; Patrick Meybohm; Jens Scholz; Matthias Fischer Journal: Crit Care Date: 2011-11-24 Impact factor: 9.097
Authors: Sebastian Bergrath; Michael Czaplik; Rolf Rossaint; Frederik Hirsch; Stefan Kurt Beckers; Bernd Valentin; Daniel Wielpütz; Marie-Thérèse Schneiders; Jörg Christian Brokmann Journal: Scand J Trauma Resusc Emerg Med Date: 2013-07-11 Impact factor: 2.953