Holroyd B R, Knopp R, Kallsen G
JAMA. 1986;256(8):1027-31. doi: 10.1001/jama.256.8.1027.
Medical control is an essential component of a prehospital care system. It is a method of ensuring quality and accountability of the care provided and thus provides a method of risk management for the system. Politicians, fire departments, ambulance companies, physicians, and others are struggling for control of prehospital emergency care. Unless physicians are willing to become involved and provide leadership for prehospital care, it will be impossible to establish quality care. Physician input must be involved throughout planning, implementation, and evaluation of an EMS system. It is mandatory that physicians experienced in emergency care of the acutely ill or injured patient direct all medical aspects of the prehospital care system and provide ongoing review of the system. Medical control includes three phases: prospective, immediate, and retrospective. The incorporation of medical control in a specific EMS system will be dependent on that system's characteristics; nevertheless, proper medical control is essential to ensure a high quality of prehospital care. Further studies will be necessary to evaluate medical control and determine the best mechanism for providing quality assurance in prehospital care.
医疗控制是院前急救系统的重要组成部分。它是一种确保所提供医疗服务质量和问责制的方法，从而为该系统提供了一种风险管理方法。政治家、消防部门、救护车公司、医生及其他各方都在争夺院前急救的控制权。除非医生愿意参与并为院前急救提供领导，否则就不可能建立高质量的医疗服务。在急救医疗服务（EMS）系统的规划、实施和评估过程中，必须有医生的参与。必须由在急重症患者或受伤患者的急救方面经验丰富的医生指导院前急救系统的所有医疗方面，并对该系统进行持续审查。医疗控制包括三个阶段：前瞻性、即时性和回顾性。将医疗控制纳入特定的急救医疗服务系统将取决于该系统的特点；然而，适当的医疗控制对于确保高质量的院前急救至关重要。有必要进行进一步的研究，以评估医疗控制并确定在院前急救中提供质量保证的最佳机制。
