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Audit of an Emergency Ambulance Service: Impact of a Paramedic System

The purpose of this survey was to assess the workload of an emergency ambulance service, to describe the use of paramedic skills by those staff with full extended training, and to predict the impact upon the provision of pre-hospital care of deploying a paramedic on every emergency ambulance. Accord...

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Detalles Bibliográficos
Autores principales: Weston, Clive F. M., McCabe, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Physicians of London 1992
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375429/
https://www.ncbi.nlm.nih.gov/pubmed/1573593
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author Weston, Clive F. M.
McCabe, Michael J.
author_facet Weston, Clive F. M.
McCabe, Michael J.
author_sort Weston, Clive F. M.
collection PubMed
description The purpose of this survey was to assess the workload of an emergency ambulance service, to describe the use of paramedic skills by those staff with full extended training, and to predict the impact upon the provision of pre-hospital care of deploying a paramedic on every emergency ambulance. Accordingly, a week-long survey was undertaken of all urgent and emergency calls received by an ambulance service covering a mixed urban and semi-rural area of 187 square miles with a population of 396,000. Of the total 682 emergency calls 351 (51.5%) originated from the '999' system: 291 of these patients were taken to hospital where 51% were thought to have minor conditions and 141 were admitted. General practitioners made 236 (34.6%) emergency calls: 234 patients were taken to hospital where 76.4% were thought to have potentially serious conditions or an acute risk to life and 217 were admitted. There was no difference in the type or severity of conditions attended by paramedic or non-paramedic crews. Time spent on-scene was significantly longer when paramedics were present (mean 11.0 min, 95% confidence interval 9.54–12.46 min v 8.31 min, 7.49–9.13 min) (p < 0.01). Extended skills were used by paramedics in 42 (23.6%) of their patients, most of whom were medical cases. One patient was resuscitated from cardiac arrest. The presence of a paramedic on every emergency ambulance increases the time spent on-scene and offers advanced pre-hospital skills to patients who need them. Care should be taken to ensure that the benefits of time spent on-scene using such skills outweigh the disadvantage of delayed hospital admission.
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spelling pubmed-53754292019-01-22 Audit of an Emergency Ambulance Service: Impact of a Paramedic System Weston, Clive F. M. McCabe, Michael J. J R Coll Physicians Lond Medical Audit The purpose of this survey was to assess the workload of an emergency ambulance service, to describe the use of paramedic skills by those staff with full extended training, and to predict the impact upon the provision of pre-hospital care of deploying a paramedic on every emergency ambulance. Accordingly, a week-long survey was undertaken of all urgent and emergency calls received by an ambulance service covering a mixed urban and semi-rural area of 187 square miles with a population of 396,000. Of the total 682 emergency calls 351 (51.5%) originated from the '999' system: 291 of these patients were taken to hospital where 51% were thought to have minor conditions and 141 were admitted. General practitioners made 236 (34.6%) emergency calls: 234 patients were taken to hospital where 76.4% were thought to have potentially serious conditions or an acute risk to life and 217 were admitted. There was no difference in the type or severity of conditions attended by paramedic or non-paramedic crews. Time spent on-scene was significantly longer when paramedics were present (mean 11.0 min, 95% confidence interval 9.54–12.46 min v 8.31 min, 7.49–9.13 min) (p < 0.01). Extended skills were used by paramedics in 42 (23.6%) of their patients, most of whom were medical cases. One patient was resuscitated from cardiac arrest. The presence of a paramedic on every emergency ambulance increases the time spent on-scene and offers advanced pre-hospital skills to patients who need them. Care should be taken to ensure that the benefits of time spent on-scene using such skills outweigh the disadvantage of delayed hospital admission. Royal College of Physicians of London 1992-01 /pmc/articles/PMC5375429/ /pubmed/1573593 Text en © Journal of the Royal College of Physicians of London 1992 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits non-commercial use and redistribution provided that the original author and source are credited.
spellingShingle Medical Audit
Weston, Clive F. M.
McCabe, Michael J.
Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title_full Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title_fullStr Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title_full_unstemmed Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title_short Audit of an Emergency Ambulance Service: Impact of a Paramedic System
title_sort audit of an emergency ambulance service: impact of a paramedic system
topic Medical Audit
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5375429/
https://www.ncbi.nlm.nih.gov/pubmed/1573593
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