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Barriers Hinder EMS Workers From Using Best Resuscitation Practices
Date:6/30/2009

American Heart Association Rapid Access Journal Report:

Study highlights:

Cardiac arrest patients may not be getting the best care by EMS personnel due to a number of external factors.

EMS should have adequate time in the field to give high-quality CPR and other resuscitation efforts before transporting cardiac arrest patients.

EMS should follow national guidelines for transporting cardiac arrest patients and determining when to end unsuccessful resuscitation efforts.

DALLAS, June 30 /PRNewswire-USNewswire/ -- Local laws, insurance reimbursement and public misperceptions impede emergency medical services (EMS) workers from using best resuscitation practices, according to a study reported in Circulation: Cardiovascular Quality and Outcomes.

Less than half of local EMS systems follow national guidelines on transporting cardiac arrest patients and terminating unsuccessful out-of-hospital resuscitation efforts, said researchers who conducted three small focus groups at the 2008 National Association of Emergency Medical Services Physicians meeting in Jacksonville, Fla.

Each focus group had four to 12 participants. The majority (79.1 percent) were physicians, and 66.7 percent were EMS directors at a wide variety of practice settings.

Based on the focus group analysis, researchers identified three key areas where policies or perceptions may impede local efforts to follow the guidelines for terminating unsuccessful resuscitation efforts:

  • Private insurers and Medicare who provide higher reimbursement to EMS for patient transport, regardless of whether the cardiac arrest victim is successfully resuscitated in the field or not;
  • state legislation that requires transport to hospitals and restricts the ability of responders to follow do-not-resuscitate (DNR) orders; and

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SOURCE American Heart Association
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