But in the link above, he makes one error:
Despite what you see on television, the prognosis for cardiac arrest is grim. Grim of not, when I have mine, I want the following sequence of events to take place:
1. Chest pain
2. 999
3. Paramedics
4. Hospital and doctors
5. Undertakers
I do not mind omitting (5) but I do not want my chance of arriving in (4) to be prejudiced by (3). Call me silly, but I do not believe that paramedics have the same skills and equipment as doctors in hospital.
The error is probably due to a few different reasons. The scope of practice for paramedics in the UK could be different than it is in the USA. Regional geographical differences can be a complicating factor (which, I will admit, he does mention.) There may be a measure of territorialism. Don't know.
But the error is there: For all but the most unique cases of medical cardiac arrest, there is little the hospital staff will or can do that the properly trained and equipped paramedic can not.
Yes, the hospital can do some stuff we, paramedics, can not. Chest x-rays, Arterial Blood Gases, Chemistry panel blood tests, and so forth. However, in my years of experience, very few cases will get these tests done. Most cardiac arrests will get adequate airway management, IV therapy including medications, chest compressions, and a "good run" of time to see if anything works.
While certain unique situations exist that justify prehospital staff transporting a patient in cardiac arrest (say, violence or risk of violence towards paramedics -- "if my Mom dies, so do you" said one patient's son as he held his firearm -- or patients with acute hypothermia, etc.), by and large the risks associated with transport outweigh the benefits (or lack thereof) of transport.
Are paramedics as educated and knowledgeable as physicians? No way. Not a chance. Not. Even. Close.
For these patients, however, I don't see the benefit. Maybe it's just me.
1 snarky observations:
You and the American Heart Association. Who also recommends against routine transport of cardiac arrest patients who don't respond to treatment in the field.
If you read the blog of an English EMT, you won't see a huge difference in care between our two nations.
Absent some underlying mitigating circumstances, there isn't much to be gained by driving dead people to the hospital.
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