The role of paramedics and assodiated problems.
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概要
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In the emergency medical system (EMS), early response and appropriate prehospital care are the most important factors in preventing out-of-hospital deaths. The EMS Act was enacted in the United States in 1973, because deaths from heart attacks and traffic accidents increased between 1960 and 1970, and the great majority of these deaths took place outside hospitals. The American Heart Association (AHA) adopted and supported the Emergency Cardiac Care (ECC) System concept described in "Standards and Guidelines". As a result, emergency medical technicians (EMT) were allowed to provide prehospital care, including basic life support (BLS) and advanced life support (ALS), on scene. Currently, EMT-P (so-called paramedics) provide ALS to heart attack and trauma victims as prehospital care in the United States and European countries. In Japan, the life saving technician (LST) Act was enacted in 1992 to provide prehospital care to patients who experienced out-of-hospital cardiopulmonary arrest, but it has not yet been evaluated. Therefore, EMS of European countries and the United States are explained refered to inspection reports of Japanese government agencies, and the background of Japanese EMS are refered to enacted LST Act. The role of paramedics in training EMTs and the CPR education of citizenes are explained, and on-the-scene prehospital care procedures are discussed by refered to literatures. Paramedics are basically permitted to institute routine ALS procedures-endotracheal intubation, intravenous access, fluid administration, and defibrillation-according to protocol before medical control contact. Recently, paramedics have been permitted to perform prehospital ICT of acute myocardial infarction, and are permitted endotracheal intubation with succinylcholine and administer more than 2 liters of fluid intravenously to trauma patients on the scene with medical supervision. However new problems in prehospital care have been raised, exposed of paramedics to exposured hepatitis B virus and human immunodeficiency virus during prehospital procedures, and delays in hospital arrival there by decreasing the effectiveness of hospital-delivered treatment. The outline of EMS and paramedics are refered to litaretures, and lastly the differences between prehospital care provided Japanese LSTs and paramedics in other countries are pointed out.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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