Volume 8 Issue 1

That final fatal error: crew resource management

Providing safe clinical care to the community is the cornerstone of modern paramedic practice. Crew resource management (CRM) is a strategy to investigate and mitigate errors and research into these concepts is limited in paramedicine. A conceptual framework specific to CRM in paramedicine in needed. The Egg Timer Model of Disparity, designed by Willis and published in Summers and Willis (2010), is put forward as a conceptual model worthy of explorative review.

Incidence, response, and outcomes of cardiac arrest in Portland, Oregon

Cardiac arrest is a serious medical event with a poor prognosis of survival, at less than 10% (Zive et al, 2011). Several studies have investigated out-of-hospital cardiac arrest (OHCA) response, treatment, and outcomes. Cardiac arrest databases such as the Resuscitation Outcomes Consortium (ROC) and the Cardiac Arrest Registry to Enhance Survival (CARES) have been created to provide evidence-based findings to develop emergency medical service (EMS) policies for treatment. The current study was completed to describe the cardiac arrest characteristics and outcomes of the EMS provider, American Medical Response (AMR) in Portland, Oregon, United States (US), for three metropolitan counties of approximately 1.6 million people (US Census Bureau, 2016a; 2016b; 2016c). The retrospective study described in this article used the AMR Multiple-EMS Data Systems (MEDS) database to generate data. Between 1 January 2013 and 31 December 2014, AMR responded to 2029 cardiac arrest events. In total, 45% of these cases were pronounced dead at the scene or untreated, and 55% were treated by paramedics. The most noteworthy finding was the effect of cardiopulmonary resuscitation (CPR) on successful return of spontaneous circulation and survival evidenced by the large differences in odds ratios and bivariate counts with CPR treatment. The study adds to the current knowledge base of OHCAs and builds upon existing cardiac arrest registries—particularly within the Portland Oregon (US) metropolitan area.

Contributions to public health around the world

The paramedic profession continues to establish itself in many healthcare settings across the world. A lack of common understanding of the role globally, as well as the differing nature of healthcare systems, can result in difficulties relating research carried out in one setting to another.