Any A+E consultant who thinks they send their staff on ALS courses to
improve their management of pre-hospital arrests is just being daft. The
reason your ALS success rate has not moved is because you are looking at the
wrong treatment for the wrong patients.
For pre-hospital arrests you achieve good outcomes with high community BLS
rates, community AED programs and good EMS systems. Your standard of ALS
has very little to do with it.
To improve prehospital arrest figures, you should be looking at educating
chest pains to call for help early, community programs for BLS and AEDs (ie:
Public Access Defibrillation programs and first responder programs), the
ambulance response times, paramedic protocols for calling death at the scene
or BASICS schemes to send a doctor to the scene etc..
I give a 999 response to my asthmatics and chest pain patients because I
want to get to them BEFORE they arrest. I know that if I get called after
they arrest I might as well finish watching "Who Wants to be a Millionaire"
first.
The idea of teaching ALS to A+E staff is to improve your results with the
patients who are peri-arrest when they arrive or arrest AFTER they arrive in
your dept.
Robbie Coull
email: [log in to unmask] website: http://www.coull.net
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