Home Medizin Neue Studie zeigt inkonsistente Versorgung in Rettungsdienstsystemen in den Vereinigten Staaten

Neue Studie zeigt inkonsistente Versorgung in Rettungsdienstsystemen in den Vereinigten Staaten

von NFI Redaktion

According to a new study by the Icahn School of Medicine of Mount Sinai, emergency medical services (EMS) systems do not consistently provide optimal care based on new national quality standards to patients who call the 911 emergency number.

The study reveals that the performance of EMS in vital clinical and patient safety measures in urban and rural communities varies significantly. The findings were published in the February 13 edition of Prehospital Emergency Care, identifying opportunities that could lead to improved care in 911 responses and better outcomes for patients across the United States.

„Emergency medical services (EMS) systems in the United States traditionally rely on operational measures such as response times to gauge the overall performance of the system. However, this study underscores that patient care and experience are not solely dependent on how quickly an ambulance can arrive at the patient’s location. While rapid response times are essential for rare critical incidents – such as when a patient’s heart stops beating or someone is choking – the vast majority of patients benefit from disease-specific clinical care in the early stages of a medical emergency. For EMS, government officials, and the public, it is critical to understand the quality and safety of the existing care and find ways to improve it,“ said Michael Redlener, MD, lead author and associate professor of emergency medicine at Icahn Mount Sinai.

This is the first study to use specific safety and clinical quality measures to assess patient care throughout the 911 system in the United States. The research team examined all 911 responses in the United States for the year 2019, totaling over 26 million responses from 9,679 EMS agencies. They evaluated specific quality measures set forth by the National EMS Quality Alliance – a nonprofit organization established to develop and support evidence-based quality measures for EMS and healthcare partners to enhance patient and provider experiences and outcomes. These measures include the treatment of low blood sugar, seizures, strokes, pain and trauma, as well as medication safety and transport safety. Some of the notable findings included:

  • Pain relief improved in only 16 percent of trauma patients after treatment by EMS.
  • 39 percent of children with wheezing or asthma attacks did not receive breathing treatments during their emergency call, although earlier treatment could lead to earlier relief of distressing symptoms.
  • Nearly one-third of patients suspected of having a stroke did not have a stroke assessment documented, potentially causing a delay or missed time-critical treatment.

The researchers also analyzed the performance of all EMS agencies, considering their size and location – urban, suburban, and rural. They found significant differences between agencies primarily responding in rural communities compared to urban and suburban areas. In comparison to EMS systems in urban and suburban communities, agencies primarily serving rural areas were less likely to treat low blood sugar or alleviate the pain of trauma patients, and were more likely to use lights and sirens unnecessarily. Previous studies have shown that the use of lights and sirens during ambulance transport increases the likelihood of accidents, injuries, and deaths, making unnecessary use potentially hazardous. According to Dr. Redlener, the difference between the highest and lowest-performing agencies in these key measures is remarkable and not attributable to random variation.

„This work is not about pointing fingers at poor-performing EMS, but about identifying opportunities to improve patient care,“ Dr. Redlener adds. „We need to move away from just looking at response times and start focusing on performance that directly impacts the people we are supposed to treat.“

Source:

The Mount Sinai Hospital / Mount Sinai School of Medicine

Journal reference:

Redlener, M., et al. (2024) A national assessment of EMS performance at the response and agency level. Prehospital Emergency Care. doi.org/10.1080/10903127.2023.2283886.

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