A comparison of ambulance responses to incidents of Medical Emergency Teams led by nurses and paramedics--A retrospective single-center study

摘要

Background: In Poland there are currently two main types of Medical Emergency Team: basic, run by nurses or paramedics, and specialist, led by physicians. They differ not only in professional qualifications but also in their terms of reference. Objectives: We compared the responses to incidents of Medical Emergency Teams led by nurses and paramedics, in terms of the frequency of pharmacotherapy use and medical rescue activities. Study design: Ambulance call reports. Settings: Medical Emergency Teams in Eastern Poland. Participants: Medical Emergency Teams led by nurses or paramedics. Exclusion criteria were cancelation of calls by the dispatcher, calls with no patient on the scene, and neonatal and interhospital transportation. Methods: A retrospective analysis of ambulance call reports. A comparison of actions of nurses and paramedics taken in the field, and decisions concerning transportation of the patient to a hospital or leaving the home were collected. Results: Of 1115 Medical Emergency Teams calls, those led by paramedics (60.5%) were more common. Paramedics, more often than nurses, provided aid solely in the field-27.5% and 16.0%, respectively-and less frequently transported patients to the hospital-38.5% and 50.7%, respectively. Significant differences in administration of oxygen therapy and analgesics were identified; paramedics used them more often than nurses. Paramedics used cervical collars, 3.6% and 1.1% (p=0.01), respectively, and performed 12-lead electrocardiograms, 4.7% and 1.4% (p=0.002), respectively, significantly more frequently than did nurses. Conclusions: Despite the comparable competency of paramedics and emergency nurses in Poland, Medical Emergency Teams' activities varied depending on whether a nurse or a paramedic was the team leader. It is recommended that further in-depth research is conducted in this area.