A Position Statement of the National Emergency Medical Services Advisory Council summarises the substantial evidence base documenting improved patient outcomes resulting from prehospital interventions and emergency medical services (EMS) systems. The fully referenced document is available in free full text .
The document concludes with this summary:
- EMS makes a difference by producing clinically meaningful reductions in time to definitive treatment and improved health outcomes for patients with STEMI. Trained EMS providers are proficient in the capture and interpretation of 12-lead ECGs, can andshould make or participate in triage decisions to bypass closer hospitals in favor of to PCI-capable facilities, when clinically indicated. Efforts should continue to educate the public to call 9-1-1 at the first sign of a heart attack.
- EMS makes a difference by decreasing the times to CPR and defibrillation, defined as the two critical factors for surviving cardiac arrest.
- EMS makes a difference and is a critical component of effective stroke care. EMS must advocate for quality, standardized stroke protocols, performance improvement systems and training, and expedient transport of stroke patients to specialty care centers. EMS systems must partner with their dispatch agencies to ensure the use of quality Emergency Medical Dispatch protocols that provide proper stroke care instructions and activate appropriate resources. Efforts should continue to educate the public to call 9-1-1 at the first sign of a stroke.
- EMS makes a difference by improving survival and neurological function for patients with respiratory emergencies. Proper prehospital care decreases the need for intubations and the number of required hospital admissions and improves cerebral performance in patients with respiratory distress. The addition of CPAP to the EMS tool kit provides immediate and longer-term benefits and further reduces hospitalization rates and healthcare costs.
- EMS makes a difference by allowing EMS providers to use diagnostic tools such as blood glucometry, pulse oximetry, and 12-lead ECGs to efficiently evaluate patients and determine whether more advanced evaluation is necessary.
- EMS makes a difference by treating many diabetic patients at home without the need for transport; thereby improving patient satisfaction and decreasing healthcare costs.
- EMS makes a difference by accurately identifying patients experiencing out-of-hospital cardiac arrest who have no realistic chance of survival and determining whether transport to a hospital is warranted, thus reducing transports, decreasing hospital and patient costs, and increasing the availability of EMS resources.
- EMS makes a difference with its expanding role in the healthcare system. EMS has the potential to provide improved patient outcomes and more customer satisfying primary care while offering clinically appropriate alternatives to hospital transport in addition to standard 9-1-1 responses. In a fully integrated healthcare system, EMS will provide preventive services, acute care, and overall community health.
- EMS makes a difference in trauma care by providing rapid assessment, early notification to trauma centers, and rapid triage and transport to trauma centers, when appropriate. EMS will continue to be the community’s safety net.
- EMS makes a difference with pediatric shock patients when shock is recognized and treated aggressively. The healthcare system must advocate for a systems approach to pediatrics similar to trauma, STEMI, and stroke systems of care and standardized training for all healthcare providers.
EMS Makes a Difference: Improved clinical outcomes and downstream healthcare savings
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