Thursday, June 21, 2007

Resuscitation in Peoria

In Emergency Medicine News, September 2006, the following was written:

"Three years ago, the physician director of the Houston EMS system with investigators at Baylor College of Medicine, the Houston Medical School at the University of Texas, and Ohio State University looked at cardiac arrest survival as a function of ambulance deployment strategy. Though limited to a single geographic area, this study showed definiteively that outcomes for cadiac arrest patents improve when they are cared for by paramedics than by basic EMT's. (Resuscitation 2003;59:97.)

"What was the difference? The busy urban area used paramedics, and a suburb used EMT's (Basic).

"The authors said the study demonstrated better response times and better skills proficency by the "targeted response" team in the urban core, or as they call it, the TR paramedics."

In Peoria, the Peoria Fire Department (PFD) is Basic. The PFD has paramedics that cannot use their skills to resuscitate patients. This unfortunate decision has been made by multiple individuals. The majority of the Peoria public is not aware that the PFD cannot resuscitate them with advanced life support when the public calls 911.

The medical literature also states that having too many paramedics trained in an area may not be ideal for patient care because an individual paramedic may not be able to keep up his/her skills with competition for procedeures by other paramedics.

Thus, the literature is begging these questions:

1. Should the PFD petition the State of Illinois and the Peoria Area EMS (PAEMS) to allow their paramedics to give advanced life support at the scene of a medical emergency? When the PFD arrives before Advanced Medical Transport (AMT) and the paramedic firemen cannot do anything but provide Basic service, that seems suboptimal if one reads and believes the medical literature regarding patients who suffer from cardiac arrest.

2. Should AMT cut their staff of paramedics so as not to dilute the skills of their own paramedics? And if the PFD paramedics were allowed to function as paramedics, less AMT paramedics may be desirable.

Peoria's City Council and PAEMS have to decide what is more important--the business and money generated by AMT or quality of pre hospital patient care in central Illinois.

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