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paramedic3

California Paramedicine Pilot Needs Its Own Architecture

Paramedicine has to be distributed and diversified, and it needs fixed territories, protocols and responsibilities. When architected together – the fabric is community health.

Outcomes

Quality of Care & Outcomes Management Movement

Medical payers are pivoting from treatment claims to outcomes, and early intervention will certainly influence outcomes. Onsite paramedics may be compensated for successful and timely treatments – a possible major source of their funding.

High Rises

Early Intervention is the Foundation of Community Health

Using the simplest strategy possible, onsite paramedics can reliably deliver very early intervention in 3 to 5 minutes, with all the priceless benefits that brings to health care.

Canary Wharf (Commons)

Endemic Risk in High Rises an Opportunity for Security Firms

The sky’s the limit for high rise construction it seems, around the world. They are tall, graceful, and of course green. But they have one dirty little secret, which is about to be cleaned up.

Tandem AED/EMS

No-Hope Highrise to HeartSmart Community with Tandem AED/EMS

The Tandem AED/EMS strategy has an in-house AED delivering its lifesaving treatment well within four minutes. EMS then arrives some minutes later to consolidate the rescue.

assassin

A Silent killer stalking high-rises

Living or working in a high-rise just about eliminates your chance of surviving a sudden cardiac arrest.

Wireless transmission of ECGs could speed up heart attack diagnosis

A high-tech system that allows physicians to receive heart data from paramedics in the field is now live at Stanford Hospital & Clinics.

AED Registry

AED Registries – Closer to the Heart?

Efforts to improve survival should focus on the prompt delivery of medical interventions. CPR and AEDs both need human partners.

Response Times

Vertical Response Interval

High Rise Buildings Take Longer to Access

Two studies have found that high rise buildings add 2.7 minutes to medical emergency responses, which means that from an event’s onset it takes about 13 minutes to get alongside the patient.

The End-to-End Protocol

New End-toEnd Protocol Enables High Rise Rescues

Medical protocols exist so that quality care can be delivered reliably. We now have to hand the ball to our public health administrators to allow such basic strategies to take hold and enable change.

29-ems-inside[1]

Six Minutes to Live or Die

“50 largest cities save only an estimated 6% to 10% of the victims of sudden cardiac arrest who realistically could be saved.”

lotus ambulance

A 160 MPH Ambulance May Not Be a Great Idea

The scary thing is nobody thought of onsite responders, even in monster Dubai high rises. And they try to convince everyone (except the pros) that 15 min responses are OK. The public needs to be told.

Deployment

28-ems-rusinek[1]

The Tragedy of late Resuscitation

Twelve minutes passed before an ambulance crew connected a defibrillator to her chest. A block paramedic might have saved her.

images

A Cure for Sudden Cardiac Arrest, but Only if It’s Close By

The famous article from the NYT in 2002, which nailed the problem, and a dozen years later – little progress. Clearly, onsite first responders are the premium solution for cardiovascular protection in complexes.

100 defibs

Extreme Deployment of AEDs is Expensive

AED overkill is expensive and presents educational issues (even in a university) when multiple brands are involved…

ICC Committee

Elevaed Code Provisions for AEDs in Elevator Lobbies are Rejected

The NFPA and ICC both rejected Elevaed’s proposals to place AEDs in high rises. In retrospect, block paramedicine is a superior strategy, with much wider promise.

CPR

For Drugs That Save Lives, a Steep Cost

“A simple syringe with a dose of naloxone should cost about $3 …but experts expect that Evzio could well be priced close to $500.”

epi

Naloxone epi-pen by prescription is just the first step

The FDA approved the equivalent of an “epi-pen” for overdose prevention, an antidote auto-injector that even untrained people can use to save the lives of those who have overdosed on drugs like Vicodin or heroin.

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How CPR Became So Popular

‘Medical creep’ happens when doctors perform procedures or prescribe treatments for patients in the absence of clear evidence that patients will benefit.

heart safety

Cheap health insurance vs our deadliest threat

Given our overweight and aging boomer generation, expect heart safety to emerge as a welcome and affordable concept.

Studies

Lidocaine

NIH Launches Trials to Evaluate CPR and Drugs

The continuing study of adjunct treatments for SCA; see also CPAP and the recent doubts about epinephrine

Study Quantifies EMS Delays in High Rises

Significant delays present when accessing patients in high-rise buildings and evacuating them to the hospital.

EMS Response Times from National Database

US National NEMSIS cardiac arrest elapsed patient care times as an average (table) and as a 90th Fractile (graph).

Paramedic response time: does it affect patient survival?

Pivotal 2005 study establishes no survival benefit from EMS arrival within 8 min – only if within 4 min.