Brown L H, Owens C F, March J A, Archino E A
East Carolina University School of Medicine, Department of Emergency Medicine, Greenville, North Carolina 27858, USA.
Prehosp Disaster Med. 1996 Jul-Sep;11(3):214-7; discussion 217-8. doi: 10.1017/s1049023x00042977.
While large cities typically staff ambulances with two emergency medical services (EMS) professionals, some EMS agencies use three people for ambulance crews. The Greenville, North Carolina, EMS agency converted from three-person to two-person EMS crews in July 1993. There are no published reports investigating the best crew size for out-of-hospital emergency care.
Two-person EMS crews perform the same number and types of interventions as three-person EMS crews. Two-person EMS crews do not have longer on-scene times than do three-person EMS crews.
Data for the two most common advanced life support calls in this system--seizures and chest pains--were collected for the months of June and August 1993. Three-person EMS crews responded to both types of calls in June. In August, two-person EMS crews responded to seizure calls; two-person EMS crews accompanied by a fire department engine (pumper) with additional manpower responded to chest pain calls. The frequency of specific interventions, number of total interventions, and scene times for the August calls were compared to their historical control groups, the June calls.
One hundred twenty-six patient contacts were included in the study. There were no significant differences in total number or types of procedures performed for the two patient groups. Mean on-scene time for patients with seizures was 11.0 +/- 4.2 minutes for three-person crews and 19.4 +/- 8.3 minutes for two-person crews (p < 0.001). Mean on-scene time for patients with chest pain was 13.6 +/- 4.9 minutes for three-person crews, and 15.4 +/- 3.2 minutes for two-person crews assisted by fire department personnel (p > 0.05).
Two-person EMS crews perform the same number of procedures as do three-person EMS crews. However, without the assistance of additional responders, two-person EMS crews may have statistically significantly longer on-scene times than three-person EMS crews.
虽然大城市的救护车通常配备两名急救医疗服务（EMS）专业人员，但一些EMS机构的救护车配备三人。北卡罗来纳州格林维尔的EMS机构于1993年7月从三人急救小组转变为两人急救小组。目前尚无已发表的报告调查院外急救的最佳人员配备规模。
两人EMS急救小组实施的干预措施数量和类型与三人EMS急救小组相同。两人EMS急救小组的现场停留时间不比三人EMS急救小组长。
收集了该系统中两种最常见的高级生命支持呼叫——癫痫发作和胸痛——在1993年6月和8月的数据。三人EMS急救小组在6月对这两种呼叫做出响应。8月，两人EMS急救小组对癫痫发作呼叫做出响应；由配备额外人力的消防部门消防车（泵浦车）陪同下的两人EMS急救小组对胸痛呼叫做出响应。将8月呼叫的特定干预频率、总干预次数和现场停留时间与其历史对照组（6月呼叫）进行比较。
该研究纳入了126次患者接触。两个患者组实施的程序总数或类型没有显著差异。癫痫发作患者的三人急救小组平均现场停留时间为11.0±4.2分钟，两人急救小组为19.4±8.3分钟（p<0.001）。胸痛患者的三人急救小组平均现场停留时间为13.6±4.9分钟，由消防部门人员协助的两人急救小组为15.4±3.2分钟（p>0.05）。
两人EMS急救小组实施的程序数量与三人EMS急救小组相同。然而，在没有额外响应人员协助的情况下，两人EMS急救小组的现场停留时间在统计学上可能比三人EMS急救小组显著更长。
