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Patient Safety: Not All Ambulances Are Created Equal

When we call 911, we feel that the best medical care possible outside of a hospital is on the way. Unfortunately, in many communities, that belief is just not true. The sophistication of the medical equipment aboard ambulances varies widely from community to community and from company to company.

The technology aboard the ambulance that comes to your door may not be the latest and greatest, and that can literally be the difference between whether a patient lives or dies, especially with cardiac arrest.

According to recent companion pieces by Laura Landro in the Wall Street Journal, a movement is afoot led by U.S. ambulance companies, local communities and first responders like EMTs to shave minutes off of access to emergency medical services. Minutes may save lives in certain scenarios.

Here are some examples of innovations being brought to some ambulance services and other emergency situations:

  • Some emergency call-center workers are learning how to guide people over the phone through CPR on heart patients.
  • Techniques used to cool the temperatures of patients with cardiac arrest are being utilized remotely by some paramedics, decreasing the risk of brain injury.
  • Some ambulances are getting technology allowing electrocardiogram results and vital statistics to be "beamed" to hospitals so in-house emergency teams are more quickly ready to act when patients arrive.
  • Bandages that rapidly clot blood are entering civilian health care from military use.
  • Some ambulances are utilizing chest-squeezing equipment that frees up staff to perform other emergency operations.

The difficulty with variation in quality of ambulance care is that emergency services are administered in different locales by different entities, including private, public (state and local government), volunteer or nonprofit. No one system is in place to see that improvements in equipment and training are made uniformly across the country.

A recent study by the National Association of State EMS Officials confirms the inconsistency in service levels among localities as well as the impact of the economic crisis on governmental resources that could be used to improve the situation.

Some nationally recognized programs are emerging, however, to provide guidance and resources, including the Culture of Safety plan at the University of Pittsburgh and CARES (Cardiac Arrest Registry to Enhance Survival) at Emory University.

Sources: "The Ultimate Lifesaver," The Wall Street Journal, 2/14/12

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