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Inconsistent EMS Care in the US

According to a new study by the Icahn School of Medicine at Mount Sinai, emergency medical services (EMS) offer different quality of care to patients calling 911. This study showed that EMS's response to patient safety differed between urban and rural areas. Pre Hospital Care points out some methods for better care when there are 911 responses, which will have positive outcomes for patients in the US. EMS services in the US usually rely on response times to measure the performance of the service. The study focuses more on condition-specific clinical care in an emergency rather than just the ambulance arriving the quickest to the patient. EMS systems, government officials, and the public should know about the quality of care they receive in hopes of improving it. 

The Icahn study is the first to utilize safety and clinical quality measures to determine the level of patient care throughout the entire 911 system in the US. The research team looked over all 911 responses in the US in 2019. The size of the population was more than 26 million responses from 9,679 EMS organizations. The researchers calculated more specific quality care measures in every call, as the National EMS Quality Alliance stated. This non-profit organization supports evidence-based quality care for EMS and healthcare partners to change patient care outcomes in EMS. These measures involved the treatment of low blood sugar, seizures, stroke, pain, trauma, and medication and transport safety. One significant result from the study was that in 16%of trauma patients, pain improved after being treated by EMS. 39% of youth with breathing issues or asthma attacks were not given any breathing treatment while on the EMS call; this is disheartening since it has been shown that treatment given earlier can result in quicker relief of symptoms. Additionally, about ⅓ of patients with signs of stroke did not have their stroke symptoms recorded, which can delay treatment for this time-sensitive condition. 

The researchers also assessed the performance of the EMS agencies in the US, recording the size and location and whether they were urban, suburban, or rural. They found out that agencies in rural areas often were less likely to care for low blood sugar or reduce pain for trauma patients but instead use loud sirens and extra lights when it is not needed compared to EMS systems in urban and suburban areas. In past studies, extra lights and loud sirens during EMS transport have correlated to a higher chance of accidents, injuries, and death. Unnecessary use can be more dangerous for the patient and individuals in the ambulance. In conclusion, the differences in the quality of care between the highest- and lowest-performing agencies are notable. They are often based on the size of the EMS and the location. However, there can be changes with all EMS implementing stroke assessment, low blood sugar treatment, breathing issues, etc, more quickly. Response time is only one of the many factors that matter when offering care in emergency medicine. 


Thank you for reading, 

Siri Nikku 



 

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