Читать книгу Emergency Medical Services - Группа авторов - Страница 48

In the decade from 1993 to 2002, the number of emergency departments and hospital inpatient beds in the United States declined at the same time the number of patients coming to emergency departments increased by 26%. The IOM began a study of hospital‐based emergency care in 2003 that rapidly expanded to address long‐standing and significant issues related to EMS and emergency care for children. EMS systems were viewed as increasingly overburdened and underfunded. The result was a three‐volume IOM report titled The Future of Emergency Care, which was released in 2006 [75]. Key findings of the report included the following: many emergency departments and trauma centers are overcrowded; emergency care is highly fragmented; critical specialists are often unavailable to provide emergency and trauma care; and EMS and emergency departments are not well equipped to handle pediatric care. Key recommendations of the report were to create coordinated, regionalized, and accountable emergency care systems; create a lead (federal) agency for emergency care; end emergency department boarding and diversion; increase funding for emergency care; enhance emergency care research; promote EMS workforce standards; and enhance pediatric presence throughout emergency care.

The IOM report was the first major report on emergency care since the 1966 NAS‐NRC report. One recommendation of particular relevance to EMS physicians was the recommendation to create a subspecialty of EMS. Other recommendations of specific interest to EMS included developing national standards for the categorization of emergency care facilities; developing evidence‐based national model EMS protocols; increasing funding for EMS preparedness; states requiring national accreditation of paramedic education programs and national certification for state licensure; and EMS agencies having pediatric coordinators to ensure appropriate equipment, training, and services for children.