A crew made up of two paramedics doesn’t seem to deliver better care than a crew made up of one paramedic and one EMT, finds a new study by American Medical Response that analyzed records of 619,000 EMS transports.
Two-paramedic crews had slightly shorter on-scene intervals and were slightly more likely to administer medications, intubate and transport to the hospital. Patients of two-paramedic crews also had a slightly better improvement in the Rapid Acute Physiology Score, which includes measures such as pulse, blood pressure, respiratory rate and the Glasgow Coma Scale. Yet none of the differences were clinically significant.
The abstract is in the January/March online issue of Prehospital Emergency Care.
Vast Majority of Helicopter EMS Transports Deemed Medically Necessary
All but 1.4 percent of nearly 28,000 helicopter emergency medical service (HEMS) transports studied were “medically appropriate,” researchers from the University of Illinois College of Medicine at Peoria have found.
Over the past decade, the number of HEMS transports has grown rapidly. Concerns about cost and safety have led some to question if all those transports are actually necessary, according to background information in the study.
Critical care registered nurses reviewed records for all flights performed in 2009 by Air Evac Lifeteam, an air medical company with more than 90 bases in 14 states, to determine their medical appropriateness. Nurses based their analysis on criteria from the Medicare Benefit Policy Manual, guidelines from the Commission on the Accreditation of Medical Transport Systems, Air Medical Physicians Association position papers, the Centers for Disease Control and Prevention’s guidelines for field triage and Medicare reimbursement appeal decisions. Flights that were questionable, and those shorter than 30 miles, were reviewed by a senior quality assurance/quality improvement nurse or a senior medical director. Utilizing this criteria, the reviewers found that only 1.4 percent of the flights were “medically inappropriate” and could have been handled by ground transport.
And even that number may be an exaggeration, researchers say, because having too few ground EMS resources in rural areas may prompt calls to HEMS since there are no other options.
“Amid growing concerns of HEMS utilization for noncritical patients, this study supports the fact that the emergency medical transport community works hard to ensure the appropriate transport of the most critically ill or injured patients,” Daniel Hankins, M.D., an emergency physician and president of the Association of Air Medical Services, said in a news release.
The abstract is in the January/March issue of Prehospital Emergency Care.
Ecstasy-Related ER Visits Surge
Ecstasy-related medical emergencies increased 75 percent between 2004 and 2008, according to a new report from the Substance Abuse and Mental Health Services Administration.
Emergency departments treated nearly 18,000 patients in 2008 for emergencies related to Ecstasy (3,4-methylenedioxymeth-amphetamine, or MDMA), which can cause agitation, high blood pressure, muscle cramping, kidney failure and heart failure. That was up from about 10,000 in 2004. About 70 percent of patients were between 18 and 29 years old, but nearly 18 percent were younger—aged 12 to 17.
About 78 percent of patients who needed emergency medical care had used Ecstasy with other drugs or alcohol, which increases the chances of an adverse reaction. Use in hot, crowded places like dance clubs or at all-night “raves” also heightens health risks, including heat stroke, the report says.
Read the full report at oas.samhsa.gov/2k11/DAWN027/Ecstasy.htm.
If You’re Going to Have a Sudden Cardiac Arrest, Hope It’s at a Gym
About 50 percent of people who suffered sudden cardiac arrest (SCA) at a gym, dance studio, bowling alley or other exercise facility survived, found a new study by researchers in Seattle and King County, Wash. That’s significantly higher than the 36 percent who survived if the SCA occurred at another indoor public location.
Researchers examined the outcomes of 960 cases of SCA occurring at indoor public locations from 1996 through 2008. Of those, 150 occurred in exercise facilities. Among the activities the latter group of victims were partaking in: playing basketball, dancing, working out, walking or running on a treadmill, playing tennis, bowling or swimming.
Those who suffered SCA at an exercise facility were more likely to have bystanders do CPR—77 percent compared to 55 percent at non-exercise public indoor facilities—and to use an AED—16 percent vs. 7 percent.
The study was presented May 5 at the Heart Rhythm 2011 scientific sessions in San Francisco.
Compassion a More Effective Response to Workplace Anger
Showing compassion to an angry employee may be more effective than punishment in solving the underlying problem, new research suggests. Researchers from Temple University’s Fox School of Business in Philadelphia asked nearly 200 people who’d witnessed an angry outburst at work how the issue was dealt with by managers.
When managers showed support for the angry employee—rather than sanctioning the worker or doing nothing in response—it helped not only to soothe workplace tensions but foster “positive change,” researchers write in the study, which appeared in the February issue of the journal Human Relations.
If managers show “an active interest in addressing underlying issues that prompted employee anger, perceptions of improved situations increase significantly,” the researchers add.
