A Doctor’s Reflection on Ambulance Design J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS J Brent Myers, MD MPH Director | Medical Director Wake County Dept of EMS
Source of Response Time Measure
De Maio: Ann Emerg Med, Volume 42(2).August Proportion of Patient’s Surviving Vs. Response Time of Defibrillator
Ultra-Time Critical = BLS Clinical ConditionUltra-time critical treatment BLS or ALS Cardiac arrestCompressions and defibrillation BLS Severe traumaHemorrhage control, reduction of fracture, rapid transport, chest decompression BLS (save for chest decompression today) AnaphylaxisIM EpinephrineBLS AsthmaInhaled beta agonist, IM Epinephrine BLS
ALS Response Times that Matter? Severe respiratory distress CPAP (can’t this be BLS?) IV medications for treatment Advanced airway management Chest pain/STEMI Dysrhythmia treatment EKG interpretation Cardiac arrest management Severe respiratory distress CPAP (can’t this be BLS?) IV medications for treatment Advanced airway management Chest pain/STEMI Dysrhythmia treatment EKG interpretation Cardiac arrest management
Summary Lighting/conspicuity that is evidence- based Climate control that is appropriate for pharmaceuticals (and pharmaceuticals that are appropriate for the climate) Speed that is measureable and can be monitored as well as attained Safe use of interior spaces Lighting/conspicuity that is evidence- based Climate control that is appropriate for pharmaceuticals (and pharmaceuticals that are appropriate for the climate) Speed that is measureable and can be monitored as well as attained Safe use of interior spaces
We succeed only as we identify in life, or in war, or in anything else a single overriding objective and make all other considerations bend to that one objective. - Eisenhower