Extended training of ambulance staff in England.

It has been widely demonstrated that it is possible to teach ambulance staffs to carry out the extended trained skills of endotracheal intubation, intravenous infusion and ventricular defilbrillation. So far in England only a few health authorities have been able to develop courses i advanced ambulance aid. Data on the costs of this training in six authorities presently operating such courses were collected, together with the costs of operating vehicles crewed by extended trained staff. Training and operating costs vary according to the different organisation of the training schemes and the way in which the extended trained staff are deployed on operational duties. Total costs vary between 235 pounds and 878 pounds per trained person per year. The experience of different health authorities in the U.K. and in the U.S.A. operating ambulance services with extended trained staff is then examined to try to identify the benefits of reduced mortality and morbidity which accrued from the introduction of the improved service. Most of this experience is concerned with reduced mortality from the treatment of out-of-hospital cardio-pulmonary arrest, and the estimates of the life-saving potential of the service varied from one area to another. The most conservative estimate was that one fully equipped, permanently available vehicle staffed by extended trained personnel would save 3-4 lives per year. Although there is very little evidence available of reduced mortality and morbidity from trauma and other sudden serious illness, some experience indicated a further 1 or 2 lives could be saved per vehicle per year.(ABSTRACT TRUNCATED AT 250 WORDS)