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January 30, 2014

British example gives hope for standardizing care

As we continue to reboot EMS in the United States, international developments in field care can provide insights as to how we might affect our health care system in positive ways. British EMS providers are working to standardize prehospital approaches to stroke and myocardial infraction care, using standardized checklists and other techniques to improve reliability and timelines of possibly critical interventions.

It might seem obvious that we should be able to rapidly and identify key signs and symptoms of these conditions and implement the appropriate care. The British study revealed care had been quite variable. By training providers to use one standardized approach, the researchers were able to demonstrate that prehospital treatment improved in application consistency across the nation.

Whether this translates to improved morbidity and mortality isn’t addressed by the researchers, and that is what really counts. But what’s intriguing about this study is that the guidelines were applied nationwide, and all participating systems showed some level of improvement. Moreover, the techniques that were employed appear simple, easy to train and replicable to other medical conditions.

Many U.S. systems are involved with research designed to improve care implementation and outcomes; the Resuscitation Outcomes Consortium is perhaps one the best-known projects that aims to perform research across multiple systems. Nationwide research may be much harder to perform here in the states, compared to the U.K. — we are a much more fractured network of service providers, with gaps of coverage and poor levels of care. But that should not keep us from keeping our collective eyes on the prize: being part of an integrated health care system providing an array of services that improve patient outcomes. Large-scale research will help us reach that lofty goal.

About the Author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.