[Initial medical treatment by paramedics in combined first aid operations of paramedics and emergency physicians].
OBJECTIVE
The present study was conducted to evaluate the quality of paramedic care and the feasibility and cost-effectiveness of sending a well-trained paramedic team to the sight of a medical emergency to initiate active medical treatment prior to the arrival of the mobile intensive care unit (MICU).


METHODS
We examined 200 cases of medical treatment initiated by paramedics before arrival of the MICU team at the site of the medical emergency. Using a questionnaire, all emergency procedures performed by the paramedic team on scene were recorded and defined as "required", "carried out", and "accurately performed". The documented emergency procedures were divided into three categories: basic procedures (e. g. positioning, CRP, oxygen administration), additional procedures (e. g. placement of iv-lines, application of intravenous medication), and routine emergency diagnostic measures (e. g. monitoring of cardiopulmonary status). Further documented were the time of onset of emergency physician treatment, and the definitive transport vehicle used. To evaluate the time required for the measures performed, three different groups were identified according to the time gap between the arrival of the paramedic and the emergency physician teams (< 3 min, 3 - 5 min and > 5 min).


RESULTS
In the 200 emergencies included in the study, 76 - 95 % of the required procedures were accurately performed prior to the arrival of the MICU team, at a success rate ranging from 87 to 100 %.


CONCLUSIONS
In this study, a large number of emergency procedures could be performed by the paramedic team within a short period of time (in some cases < 3 min), and adequate effectiveness. Based on our results, the activation of paramedic-staffed first-tier ambulances with shorter response times is recommended in addition to the MICU system.
Wahlen
B M
BM
Klinik für Anästhesiologie, Klinikum der Johannes-Gutenberg-Universität Mainz. bwahlen@web.de
Wolcke
B
B
Schneider
T
T
Thierbach
A
A
D000488:Allied Health Personnel / Q000191:economics; D000552:Ambulances / Q000191:economics; D016887:Cardiopulmonary Resuscitation; D003362:Cost-Benefit Analysis; D003422:Critical Care / Q000191:economics; D003625:Data Collection; D003933:Diagnosis; D004632:Emergency Medical Services / Q000191:economics; D005069:Evaluation Studies as Topic; D005392:First Aid / Q000191:economics; D005858:Germany; D006801:Humans; D010102:Oxygen Inhalation Therapy; D010820:Physicians; D011795:Surveys and Questionnaires