By Robert Davis
USA TODAY
Copyright 2006 Gannett Company, Inc.
WASHINGTON — The nation’s emergency medical system — from the 911 centers that take phone calls for help to the emergency rooms that have become primary treatment centers for millions of Americans — is in a dangerous state of crisis, says a new series of landmark reports.
The Institute of Medicine on Wednesday released the Future of Emergency Care reports, which were prepared by a 40-member board after a two-year investigation. The IOM advises the government on science, medical and health issues.
The reports warn that the U.S. lifesaving system is not only failing to handle daily emergencies but also could break down in the face of national disasters, including hurricanes, disease outbreaks or terrorist attacks.
“We are not prepared,” says Brent Eastman, a board member and chief medical officer at Scripps Health in San Diego. “We struggle to survive day-to-day.”
Nels Sanddal, board member and president of the Critical Illness and Trauma Foundation in Bozeman, Mont., agrees. “To ramp up” to treat high numbers of patients, he says, “we have to have backbone.”
The reports say that, on average, in every minute of every day an ambulance carrying a patient is turned away from a hospital on “diversion,” when an emergency room says it’s too full to take more patients.
That must end, says Arthur Kellermann, director of the Center for Injury Control at Emory University School of Medicine in Atlanta. “We cannot let the most time-sensitive portal in the hospital get gridlocked.”
The IOM reports detail how hundreds of thousands of lives are affected every year by EMS deficiencies that are not obvious. “What the public perceives and what is real, in many cases, there is a disconnect,” says Gail Warden, president emeritus of the Henry Ford Health System in Detroit, who chaired the panel. “In most communities, there is a crisis under the surface.”
Many emergency rooms barely can handle their daily patient loads, children don’t always get good care, and the quality of rescue services is erratic, the reports say.
And geography determines survival.
“There is a wide disparity,” says Shirley Gamble, a United Way board member in Austin. She cited a 2003 USA TODAY probe that found a 10-fold difference between major cities in cardiac arrest survival rates.
The reports say that by following the lead of those cities that save more lives, entire regions can raise the quality of their care.
Improvements to emergency medical services, Eastman says, “should be built on islands of excellence that exist today.”
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