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PERFORMANCE BENCHMARKS Figure 1: U.S. Metropolitan Municipalities EMS Medical Directors Consortium (Eagles) Key Treatment Elements for Various Clinical Entities Encountered by EMS Systems1 Condition: ST-segment elevation myocardial infarction (STEMI) Treatment bundle: • 12-lead ECG with prearrival activation of interventional cardiology team • Direct transport to PCI-capable facility, with ECG-to-PCI time < 90 mins. • Aspirin if not allergic Number needed to treat: 15 Harm avoided: Stroke, second MI or death Condition: Pulmonary edema Treatment bundle: • Nitroglycerin in absence of contraindication • CPAP phone rings in the communications center to when help arrives at their side.1 Response times should be one of many ways to measure system performance, and no medical evidence Number needed to treat: 6 Harm avoided: Need for 1 intubation Condition: Asthma Treatment bundle: • Administration of beta-agonist Number needed to treat: N/A Harm avoided: Improved respiratory status and symptom relief Condition: Seizure Treatment bundle: • Blood glucose measurement • Benzodiazepine for status epilepticus Number needed to treat: 4 Harm avoided: Persistent seizure activity supports paramedic/ALS response time goals for any condition.1 In fact, ALS response times were not associated with survival in a fve-city study of cardiac arrests.2 Increased survival was found, Condition: Trauma Treatment bundle: • Limit nonentrapment time to < 10 mins. • Direct transport to trauma center for those meeting criteria, especially those > 65 Number needed to treat: 11 (all ages); 3 (patients > 65) Harm avoided: 1 death Condition: Cardiac arrest Treatment bundle: • Response interval < 5 mins., rather than < 8 mins. Number needed to treat: 8 Harm avoided: 1 death however, in systems where more arrests were managed by each paramedic.2 Problems have been found in communities with higher numbers of paramedics per capita, because each paramedic in More Saving Lives, Less Administration & Paperwork 4 CEs online or in the classroom 4 Effcient, fexible and automated online training administration Lighten your load of administrative paperwork with an easy to use, on-demand administrative system. 24-7 EMS offers tools to manage student progress, online and classroom scheduling and automated CECBEMS reporting, allowing you more time to do what really counts – save lives. Set the standard for EMS excellence with 24-7 EMS. Learn more at 24-7ems.com/Easytraining or call 800.240.4911 today! For More Information Circle 28 on Reader Service Card 34 JUNE 2013 | EMSWORLD.com