title: Outcome following physician supervised prehospital resuscitation: a retrospective study.
abstract: BACKGROUND
  Prehospital care provided by specially trained, physician-based emergency services (P-EMS) is an integrated part of the emergency medical systems in many developed countries. To what extent P-EMS increases survival and favourable outcomes is still unclear. The aim of the study was thus to investigate ambulance runs initially assigned 'life-saving missions' with emphasis on long-term outcome in patients treated by the Mobile Emergency Care Unit (MECU) in Odense, Denmark
  
  
  METHODS
  All MECU runs are registered in a database by the attending physician, stating, among other parameters, the treatment given, outcome of the treatment and the patient's diagnosis. Over a period of 80 months from May 1 2006 to December 31 2012, all missions in which the outcome of the treatment was registered as 'life saving' were scrutinised. Initial outcome, level of competence of the caretaker and diagnosis of each patient were manually established in each case in a combined audit of the prehospital database, the discharge summary of the MECU and the medical records from the hospital. Outcome parameters were final outcome, the aetiology of the life-threatening condition and the level of competences necessary to treat the patient.
  
  
  RESULTS
  Of 25 647 patients treated by the MECU, 701 (2.7%) received prehospital 'life saving treatment'. In 596 (2.3%) patients this treatment exceeded the competences of the attending emergency medical technician or paramedic. Of these patients, 225 (0.9%) were ultimately discharged to their own home.
  
  
  CONCLUSIONS
  The present study demonstrates that anaesthesiologist administrated prehospital therapy increases the level of treatment modalities leading to an increased survival in relation to a prehospital system consisting of emergency medical technicians and paramedics alone and thus supports the concept of applying specialists in anaesthesiology in the prehospital setting especially when treating patients with cardiac arrest, patients in need of respiratory support and trauma patients.
authors.affiliation: Mobile Emergency Care Unit, Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark Faculty of Medical Sciences, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Søren
authors.initials: S
authors.lastname: Mikkelsen
authors.affiliation: Department of Anaesthesia and Emergency Medicine, St. Olavs Hospital, Trondheim, Norway.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Krüger
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Stine T
authors.initials: ST
authors.lastname: Zwisler
authors.affiliation: Faculty of Medical Sciences, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Brøchner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000706:statistics & numerical data*; D000776:Anesthesiology / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D003718:Denmark; D004632:Emergency Medical Services / Q000379:methods*; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D010819:Physician's Role; D012151:Resuscitation / Q000592:standards* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D055815:Young Adult
keywords: INTENSIVE & CRITICAL CARE