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"Advanced Life Support" Ambulances May Lead To More Deaths
HughPickens.com writes Jason Kane reports at PBS that emergency treatments delivered in ambulances that offer "Advanced Life Support" for cardiac arrest may be linked to more death, comas and brain damage than those providing "Basic Life Support." "They're taking a lot of time in the field to perform interventions that don't seem to be as effective in that environment," says Prachi Sanghavi. "Of course, these are treatments we know are good in the emergency room, but they've been pushed into the field without really being tested and the field is a much different environment." The study suggests that high-tech equipment and sophisticated treatment techniques may distract from what's most important during cardiac arrest — transporting a critically ill patient to the hospital quickly.
Basic Life Support (BLS) ambulances stick to simpler techniques, like chest compressions, basic defibrillation and hand-pumped ventilation bags to assist with breathing with more emphasis placed on getting the patient to the hospital as soon as possible. Survival rates for out-of-hospital cardiac arrest patients are extremely low regardless of the ambulance type with roughly 90 percent of the 380,000 patients who experience cardiac arrest outside of a hospital each year not surviving to hospital discharge. But researchers found that 90 days after hospitalization, patients treated in BLS ambulances were 50 percent more likely to survive than their counterparts treated with ALS. Not everyone is convinced of the conclusions. "They've done as much as they possibly can with the existing data but I'm not sure that I'm convinced they have solved all of the selection biases," says Judith R. Lave. "I would say that it should be taken as more of an indication that there may be some very significant problems here."
Basic Life Support (BLS) ambulances stick to simpler techniques, like chest compressions, basic defibrillation and hand-pumped ventilation bags to assist with breathing with more emphasis placed on getting the patient to the hospital as soon as possible. Survival rates for out-of-hospital cardiac arrest patients are extremely low regardless of the ambulance type with roughly 90 percent of the 380,000 patients who experience cardiac arrest outside of a hospital each year not surviving to hospital discharge. But researchers found that 90 days after hospitalization, patients treated in BLS ambulances were 50 percent more likely to survive than their counterparts treated with ALS. Not everyone is convinced of the conclusions. "They've done as much as they possibly can with the existing data but I'm not sure that I'm convinced they have solved all of the selection biases," says Judith R. Lave. "I would say that it should be taken as more of an indication that there may be some very significant problems here."
Field ambulances have two people.
Only 2?
When the Sapeur-pompiers premier secours truck turned up the last time I called them they had four people onboard.
If I ever needed a SMUR they'd turn up with a doctor, a nurse, a paramedic and a driver.
(This is in France).
Watch this Heartland Institute video
Different models:
http://www.ncbi.nlm.nih.gov/pm...
Te choice of model seems to be based on how recently the systems were developed, how costs are allocated, and population density.
Trying to find an article I read a while ago that was critical of the cost/benefit ratio of the French model ... will post if I do.