Fraga SJM, Stratton S, Asensio E, Castillo JM, Vega RF, Mock C

Language: Spanish
References: 16
Page: 15-23
PDF size: 107.80 Kb.

ABSTRACT

There could be differences between Mexican and American Emergency Medical Technicians (EMT) which could presumably account for changes in prehospital mortality. Methods: A questionnaire was applied among EMT of Hamilton, Tennessee, U.S. and Queretaro, Mexico, in order to compare: age, training level, years of experience, hours worked per week, working status and amount of endotracheal intubations, CPR and IV accesses performed during the previous year. The same comparison was performed between hired and volunteer Mexican EMT. Nominal variables were compared by c² and continuous variables by Student’s t or Mann-Whitney’s U. Results: There were statistical differences between groups regarding age, training level, years of experience, hours worked per week, working status, and amount of endotracheal intubations, CPR and defibrillations (p < 0.005). There were statistical differences between hired and volunteer Mexican EMT regarding hours worked per week and amount of CPR performed during the previous year. Training level did not differ between hired and volunteer EMT. The remaining procedures showed no statistical difference between groups. Discussion: Marked differences exist between Mexican and American EMT profiles. It would be sensible to improve EMT’s working and training standards, in order to improve their performance.

REFERENCES

1. Eisenberg MS, Pantridge JF, Cobb LA et al. The revolution and evolution of prehospital cardiac care. Arch Int Med 1996; 156: 1611-1619.

2. American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Guidelines 2000 for Emergency Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science, Part 12: From Science to Survival, Strengthening the Chain of Survival in Every Community. Circulation 2000; 102(Suppl I): I-358- I-370.

3. Mock CN, Jurkovich GJ. Trauma System Development in the United States Trauma Quarterly 1999; 14: 197-209.

4. Callaham M, Madsen CD. Relation of timeliness of paramedic advanced life support interventions to outcome in out-of-hospital cardiac arrest treated by first responders with defibrillators. Ann Emerg Med 1996; 27: 638-648.

5. Cummins RO, Eisenberg MS. Prehospital cardiopulmonary resuscitation. Is it Effective? JAMA 1985; 253: 2408-2412.

6. Eisenberg MS, Copass Mk, Hallstrom AP et al. Treatment of out-of-hospital cardiac arrests with rapid defibrillation by emergency medical technicians. NEJM 1980; 302: 1379-1383.

7. Eisenberg MS, Bergner L, Hallstrom A. Out-of-hospital cardiac arrest: improved survival with paramedic services. Lancet 1980; 1: 812-815.

8. Cobb LA, Alvarez H, Kopass MK. A rapid response system for out-of-hospital cardiac emergencies. Med Clin North Am 1976; 60: 283-290.

9. McManuss WF, Tresch DD, Darin JC. An effective prehospital emergency system. J Trauma 1977; 17: 304-310.

10. Arreola-Rissa C, Ruiz-Speare JO. Trauma in Mexico. Trauma Quarterly 1999; 14: 211-220.

11. Arreola-Rissa C, Mock CN, Padilla D et al. Trauma Care Systems in Urban Latin America: The Priorities should Be Prehospital and Emergency Room Management. J Trauma 1995; 39: 457-462.

12. Mock CN, Jurkovich GJ, Nii-Amon-Kotey D et al. Trauma mortality patterns in three nations at different economic levels: Implications for global trauma system development. J Trauma 1988; 44: 804-814.

13. Cummins RO, Ornato JP, Thies WH et al. Improving survival from sudden cardiac arrest: The “Chain of Survival” Concept. Circulation 1991; 83: 1832-1847.

14. Fraga JM. 089: Preparación en reanimación cardiopulmonar de los médicos egresados de la Universidad Nacional Autónoma de México. (Abstract). Rev Fac Med UNAM 1998; 41 Suppl 1: 21.

15. Arreola-Rissa C, Mock CN, Lojero-Wheatley L et al. Low-Cost improvements in prehospital trauma care in a Latin American City. J Trauma 2000; 48: 119-124.

16. Soo LH, Gray D, Young T et al. Influence of ambulance crew’s length of experience on the outcome of out-of-hospital cardiac arrest. (Abstract) Eur Heart Jour 1999; 20: 535-540.