Davis Daniel P, Garberson Lisa A, Andrusiek Douglas L, Hostler David, Daya Mohamud, Pirrallo Ronald, Craig Alan, Stephens Shannon, Larsen Jonathan, Drum Alexander F, Fowler Raymond
Department of Emergency Medicine, The University of California San Diego, San Diego, CA, USA.
Prehosp Emerg Care. 2007 Oct-Dec;11(4):369-82. doi: 10.1080/10903120701537147.
The optimal Emergency Medical Services (EMS) system characteristics have not been defined, resulting in substantial variability across systems. The Resuscitation Outcomes Consortium (ROC) is a United States-Canada research network that organized EMS agencies from 11 different systems to perform controlled trials in cardiac arrest and life-threatening trauma resuscitation.
To describe EMS systems participating in ROC using a novel framework.
Standardized surveys were created by ROC investigators and distributed to each site for completion. These included separate questions for individual hospitals, EMS agencies, and dispatch centers. Results were collated and analyzed by using descriptive statistics.
A total of 264 EMS agencies, 287 hospitals, and 154 dispatch centers were included. Agencies were described with respect to the type (fire-based, non-fire governmental, private), transport status (transport/non-transport), and training level (BLS/ALS). Hospitals were described with regard to their trauma designation and the presence of electrophysiology and cardiac catheterization laboratories. Dispatch center characteristics, including primary versus secondary public safety answering point (PSAP) status and the use of prearrival instructions, were also described. Differences in EMS system characteristics between ROC sites were observed with multiple intriguing patterns. Rural areas and fire-based agencies had more EMS units and providers per capita. This may reflect longer response and transport distances in rural areas and the additional duties of most fire-based providers. In addition, hospitals in the United States typically had catheterization laboratories, whereas Canadian hospitals generally did not. The vast majority of both primary and secondary PSAPs use computer-aided dispatch.
Similarities and differences among EMS systems participating in the ROC network were described. The framework used in this analysis may serve as a template for future EMS research.
最佳的紧急医疗服务（EMS）系统特征尚未明确，导致各系统间存在很大差异。复苏结果联盟（ROC）是一个美国 - 加拿大研究网络，它组织了来自11个不同系统的EMS机构，对心脏骤停和危及生命的创伤复苏进行对照试验。
使用一种新框架描述参与ROC的EMS系统。
ROC研究人员创建了标准化调查问卷并分发给每个站点以完成调查。这些问卷包括针对各个医院、EMS机构和调度中心的不同问题。结果通过描述性统计进行整理和分析。
共纳入了264个EMS机构、287家医院和154个调度中心。对机构的描述涉及类型（基于消防部门、非消防政府部门、私人）、运输状态（运输/非运输）和培训水平（基础生命支持/高级生命支持）。对医院的描述涉及创伤指定以及是否存在电生理和心导管实验室。还描述了调度中心的特征，包括主要与次要公共安全应答点（PSAP）状态以及院前指导的使用情况。观察到ROC站点之间EMS系统特征存在多种有趣模式的差异。农村地区和基于消防部门的机构人均拥有更多的EMS单位和提供者。这可能反映了农村地区更长的响应和运输距离以及大多数基于消防部门的提供者的额外职责。此外，美国的医院通常有心导管实验室，而加拿大的医院一般没有。绝大多数主要和次要PSAP都使用计算机辅助调度。
描述了参与ROC网络的EMS系统之间的异同。本分析中使用的框架可作为未来EMS研究的模板。
