Читать книгу Emergency Medical Services - Группа авторов - Страница 308

EMS medical directors should play a key role in developing the system design for cardiac arrest care. One potential intervention is to optimize the positioning of EMS and other resources to match areas with the most cardiac arrests. Geographic mapping systems can play an important role, illustrating not only the distribution of cardiac arrest cases throughout a community, but also variables such as the preferred placement of AEDs [109, 110]. The OPALS study reduced cardiac arrest response and defibrillation times by moving first‐responders closer to areas with more cardiac arrests [70].

Some have touted the advantages of system status management, a formal system of continuously redeploying units based on current and anticipated use [111]. Others suggest that skill dilution occurs with too many ALS personnel. They recommend using fewer ALS personnel in a tiered response fashion [111,112].^. A Scottish study reported on an initiative to better formalize the roles of senior EMS personnel, who are known to be able to contribute characteristics essential to high‐quality resuscitation, including non‐technical skills such as resuscitation team leadership, communication, and clinical decision making in a second tier, expert paramedic response to OHCA [113].