Since their introduction over 40 years ago, paramedics have been trained to deliver select advanced life support interventions in the community with the goal of reducing morbidity and mortality from cardiovascular disease and trauma. The ensuing decades witnessed a great deal of interest in paramedic care, with an exponential growth in prehospital resuscitation research. As part of the CJEM ser...

Emergency medical services (EMS) systems, and prehospital care are difficult to evaluate. Accordingly, the true efficacy and value of such systems are difficult to determine. The multitude of variations and combinations of involved factors makes standardisation and comparison difficult, and universal indicators are hard to develop. Various attempts have been made to determine valid indicators o...

OBJECTIVES Few low income countries have emergency medical services to provide prehospital medical care and transport to road traffic crash casualties. In Ghana most roadway casualties receive care and transport to the hospital from taxi, bus, or truck drivers. This study reports the methods used to devise a model for prehospital trauma training for commercial drivers in Ghana. METHODS Over 3...

BACKGROUND Prehospital care is classified into ALS- (advanced life support) and BLS- (basic life support) levels according to the methods used. ALS-level prehospital care uses invasive methods, such as intravenous fluids, medications and intubation. However, the effectiveness of ALS care compared to BLS has been questionable. AIM The aim of this systematic review is to compare the effectivene...

BACKGROUND The Mission: Lifeline STEMI Systems Accelerator program, implemented in 16 US metropolitan regions, resulted in more patients receiving timely reperfusion. We assessed whether implementing key care processes was associated with system performance improvement. METHODS AND RESULTS Hospitals (n=167 with 23 498 ST-segment-elevation myocardial infarction patients) were surveyed before (...

retains a physician medical consultant to oversee clinical aspects of the system including the Rhode Island Prehospital Care Protocols and Standing Orders. The most unique characteristic of Rhode Island emergency medical services is the absence of a mandate requiring individual agencies to have a medical director. While the most visible component of the system is the nearly 400 licensed ambulan...

BACKGROUND Afghanistan has struggled with several decades of well-documented conflict, increasing the importance of providing emergency services to its citizens. However, little is known about the country's capacity to provide such care. METHODS Three native-speaking Afghan-American physicians performed an assessment of emergency care via combined quantitative and qualitative survey tools. Ho...