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Study: BLS patients have higher rates of survival than ALS ones

Research found that the patient population studied were more likely to survive if transported in a BLS ambulance rather than an ALS one


CHICAGO — Patients suffering cardiac arrest, stroke or other life-threatening emergencies have better rates of survival if treated and transported to the hospital on a BLS ambulance rather than an ALS one, a new study reported.

"It's counterintuitive," Prachi Sanghavi, assistant professor in public health sciences at the University of Chicago and principal author of the study, told The Washington Post. "We have a tendency to believe that things labeled 'advanced' must do better."

The study found that ALS medics take longer than clinicians in hospitals to perform procedures, such as the administration of intravenous fluids and drugs and intubation.

For these reasons, according to the research, BLS crews achieve a higher patient survivability.

EMTs focus on getting patients to the hospital as quickly as possible, implementing simpler techniques.

"The amount of time to deliver the advanced interventions just isn't worth it," Sanghavi said.

Emergency medicine physicians dispute the research’s conclusion.

"Their premise is flawed," said Howard Mell, a spokesman for the American College of Emergency Physicians and director of emergency services in Iredell County, N.C. He said ALS ambulances transport much more serious patients. "That's why they have much worse outcomes."

The study analyzed survival outcomes for about 400,000 Medicare patients between 2006 and 2011.

Some of the findings were:

  • Patients with cardiac arrest were 5.9 percentage points more likely to survive for 90 days after the accident if they were transported in a BLS ambulance rather than an ALS one.
  • Stroke patients were 4.3 percentage points more likely to survive for 90 days if they were transported in a BLS ambulance.
  • Critical major trauma patients were 12.5 percentage points more likely to survive for 90 days if they were transported in a BLS ambulance.

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