NCJ Number
56064
Journal
Evaluation and The Health Professions Volume: 1 Issue: 5 Dated: (MARCH 1979) Pages: 3-19
Date Published
1979
Length
17 pages
Annotation
AFTER REVIEWING THE QUALIFICATIONS A FIELD STUDY SHOULD POSSESS, THIS PAPER DETAILS A 'NATURAL EXPERIMENT' FROM KING COUNTY, WASH. THIS STUDY FOUND THAT PARAMEDICAL SERVICES SIGNIFICANTLY REDUCE CARDIAC ARREST DEATHS.
Abstract
THE FIRST PORTION OF THE PAPER EXPLAINS THAT A TRUE EXPERIMENT WHICH RANDOMLY ASSIGNS PERSONS TO A TREATMENT OR A NONTREATMENT GROUP IS POLITICALLY AND MORALLY UNPALATABLE WHEN EVALUATING HEALTH SERVICES. QUASI-EXPERIMENTAL DESIGNS OR 'NATURAL EXPERIMENTS' ARE NEEDED. THESE SITUATIONS SHOULD NECESSITATE DIFFERENTIAL TREATMENT FOR A DEFINABLE PROBLEM WHICH IS COMMON ENOUGH TO PROVIDE A SIGNIFICANT NUMBER OF CASES OVER A RELATIVELY SHORT PERIOD OF TIME. SUCH A SITUATION WAS FOUND IN THE SUBURBAN COMMUNITIES AROUND SEATTLE, WASH. TWO COMMUNITIES HAD COMPREHENSIVE PARAMEDICAL EMERGENCY SERVICES IN ADDITION TO THE EMERGENCY MEDICAL TREATMENT (EMT) ADMINISTERED BY THE FIRE DEPARTMENT. TWO COMMUNITIES INSTITUTED PARAMEDIC PROGRAMS DURING THE COURSE OF THE STUDY. ONE COMMUNITY HAD AN EMT PROGRAM ALONE. PRELIMINARY RESULTS ARE BASED ON THE OUTCOME OF CARDIAC ARREST CASES, FOR WHICH DATA ARE EASILY OBTAINED. WHEN THE PARAMEDIC PROGRAM WAS INTRODUCED, SUCCESSFUL RESUSCITATION OF CARDIAC ARREST CASES INCREASED FROM 20 TO 32 PERCENT WHILE DISCHARGES FROM THE HOSPITAL ROSE FROM 8 TO 18 PERCENT. IT WAS ALSO FOUND THAT IF CARDIOPULMONARY RESUSCITATION WERE STARTED WITHIN 4 MINUTES AND DEFINITIVE CARE WITHIN 8 MINUTES OF THE CARDIAC ARREST, 51 PERCENT OF THE PATIENTS WERE DISCHARGED FROM THE HOSPITAL. AS A RESULT OF THIS STUDY, FIRE DEPARTMENT EMT TEAMS ARE BEING TRAINED TO USE DEFIBRILLATION EQUIPMENT IN SUCH CASES. TABLES PRESENT STUDY DATA. REFERENCES ARE APPENDED. (GLR)