Is Prehospital Advanced Life Support Harmful?
Authors: Comilla Sasson, Jason S. Haukoos
Journal: Annals of Internal Medicine (2015)

Editorials3 November 2015Is Prehospital Advanced Life Support Harmful?Comilla Sasson, MD, PhD and Jason S. Haukoos, MD, MScComilla Sasson, MD, PhDFrom University of Colorado, Aurora, Colorado, and Denver Health Medical Center, Denver, Colorado.Search for more papers by this author and Jason S. Haukoos, MD, MScFrom University of Colorado, Aurora, Colorado, and Denver Health Medical Center, Denver, Colorado.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2192 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Each year in the United States, approximately 21 million persons call 911, are evaluated by emergency medical services (EMS), and are transported to emergency departments (EDs) for potential medical emergencies (1). Of these, approximately 35% are related to injuries or chest, respiratory, or neurologic symptoms and more than one third of all patients aged 65 years or older are transported to the ED by ambulance (1, 2). Ambulance transport to the hospital is a common and costly intervention.At the time of a 911 call, the dispatcher must quickly determine if basic or advanced care is needed, often with little ...References1. National Center for Health Statistics. Ambulatory health care data. Hyattsville, MD: National Center for Health Statistics; 2011. Accessed at www.cdc.gov/nchs/ahcd.htm on 15 September 2015. Google Scholar2. Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. Natl Health Stat Report. 2008:1-38. [PMID: 18958996] MedlineGoogle Scholar3. Sanghavi P, Jena AB, Newhouse JP, Zaslavsky AM. Outcomes of basic versus advanced life support for out-of-hospital medical emergencies. Ann Intern Med. 2015;163:681-90. doi:10.7326/M15-0557 LinkGoogle Scholar4. O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, et al; CF/AHA Task Force. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127:529-55. [PMID: 23247303] doi:10.1161/CIR.0b013e3182742c84 CrossrefMedlineGoogle Scholar5. Rokos IC, French WJ, Koenig WJ, Stratton SJ, Nighswonger B, Strunk B, et al. Integration of pre-hospital electrocardiograms and ST-elevation myocardial infarction receiving center (SRC) networks: impact on door-to-balloon times across 10 independent regions. JACC Cardiovasc Interv. 2009;2:339-46. [PMID: 19463447] doi:10.1016/j.jcin.2008.11.013 CrossrefMedlineGoogle Scholar6. Jollis JG, Al-Khalidi HR, Monk L, Roettig ML, Garvey JL, Aluko AO, et al; Regional Approach to Cardiovascular Emergencies (RACE) Investigators. Expansion of a regional ST-segment-elevation myocardial infarction system to an entire state. Circulation. 2012;126:189-95. [PMID: 22665718] doi:10.1161/CIRCULATIONAHA.111.068049 CrossrefMedlineGoogle Scholar7. Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, DeMaio VJ, et al; Ontario Prehospital Advanced Life Support Study Group. Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med. 2004;351:647-56. [PMID: 15306666] CrossrefMedlineGoogle Scholar8. Stiell IG, Nesbitt LP, Pickett W, Munkley D, Spaite DW, Banek J, et al; OPALS Study Group. The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. CMAJ. 2008;178:1141-52. [PMID: 18427089] doi:10.1503/cmaj.071154 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Colorado, Aurora, Colorado, and Denver Health Medical Center, Denver, Colorado.Disclaimer: The views expressed are those of the authors and do not necessarily represent those of the American Heart Association or the National Institutes of Health.Acknowledgment: The authors thank Christopher B. Colwell, MD; Kevin E. McVaney, MD; Peter T. Pons, MD; and Rose Marie Robertson, MD, for their input during the conceptual development of this article.Grant Support: In part by the National Institutes of Health (R01AI106057; Dr. Haukoos).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2192.Corresponding Author: Comilla Sasson, MD, PhD, University of Colorado, 12401 East 17th Avenue, Aurora, CO 80045; e-mail, comilla.[email protected]edu.Current Author Addresses: Dr. Sasson: University of Colorado, 12401 East 17th Avenue, Aurora, CO 80045.Dr. Haukoos: Denver Health Medical Center, 777 Bannock Street, Mail Code 0108, Denver, CO 80204.This article was published online first at www.annals.org on 13 October 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOutcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies Prachi Sanghavi , Anupam B. Jena , Joseph P. Newhouse , and Alan M. Zaslavsky Celebrating the ACP Centennial: From the Annals Archive—Emergency Response and Life Support Deputy Editor Deborah Cotton Celebrating the ACP Centennial: From the Annals Archive—Emergency Response and Life Support Deputy Editor Deborah Cotton Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies Prachi Sanghavi , Anupam B. Jena , Joseph P. Newhouse , and Alan M. Zaslavsky Is Prehospital Advanced Life Support Harmful? Jason S. Haukoos and Comilla Sasson Is Prehospital Advanced Life Support Harmful? Prachi Sanghavi , Anupam B. Jena , Joseph P. Newhouse , and Alan M. Zaslavsky Metrics Cited byPrehospital ResuscitationIs Prehospital Advanced Life Support Harmful?Prachi Sanghavi, PhD, Anupam B. Jena, MD, PhD, Joseph P. Newhouse, PhD, and Alan M. Zaslavsky, PhD 3 November 2015Volume 163, Issue 9Page: 721-722KeywordsHeartInstrumental variable analysisMedicarePercutaneous coronary interventionResearch laboratoriesRespiratory failureStroke ePublished: 13 October 2015 Issue Published: 3 November 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...