Role of the physician in prehospital management of trauma: North American perspective

Current Opinion in Critical Care

Volumn 8, Issue 6, 2002, Pages 551-558

  Benitez, Fernando L ^a,c   Pepe, Paul E ^a,b,c  

^a UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

^b UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

^c UTSW BioTel EMS System MC 8890   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADMINISTRATIVE PERSONNEL; CLINICAL EDUCATION; CONTRACT; EMERGENCY HEALTH SERVICE; EMERGENCY TREATMENT; EMPLOYEE; EMPLOYMENT; FIRST AID; HEALTH CARE QUALITY; HUMAN; INJURY; MEDICAL PRACTICE; MEDICAL SPECIALIST; NORTH AMERICA; PARAMEDICAL PERSONNEL; PATIENT CARE; PHYSICIAN ATTITUDE; PRIMARY MEDICAL CARE; RESUSCITATION; REVIEW; SKILL; TEAMWORK;

EMERGENCY MEDICAL SERVICES; EMERGENCY MEDICAL TECHNICIANS; EMERGENCY MEDICINE; HUMANS; NORTH AMERICA; PATIENT CARE TEAM; PHYSICIAN EXECUTIVES; PHYSICIAN'S ROLE;

EID: 0036892558     PISSN: 10705295     EISSN: None     Source Type: Journal    
DOI: 10.1097/00075198-200212000-00012     Document Type: Review

References (30)

1. National Safety Council: Injury Facts: 2000 Edition. Itasca, IL: National Safety, Council;2000:1-15.
2. Pepe PE: Current issues in resuscitative trauma management: An overview. Curr Opin Crit Care 2001, 7:409-412. This recent overview articulates some of the pros and cons of the European and North American trauma care systems and the issues of skills frequency and outcome.
3. Pepe PE, Mattox KL, Fischer RP, et al.: Geographic patterns of urban trauma according to mechanism and severity of injury. J Trauma 1990, 30:1125-1132.
4. Pepe PE, Copass MK: Prehospital care. In Early Care of the Injured. Edited by Moore EE. Toronto: BC Decker;1990:34-55.
5. Benitez FL, Pepe PE: On-scene supervision. In Prehospital Systems and Medical Oversight, Edn. 3. Edited by Kuehl AE. Dubuque, IA: Kendall/Hunt;2002:330-339. Although this is a book chapter, it is an up-to-date, state-of-the-art original publication for the National Association of EMS Physicians. It provides the major rationale and mechanisms for physician involvement in on-scene medical care in North American EMS systems.
6. Pepe PE: Bonnin MJ, Mattox KL: Regulating the scope of emergency medical services. Prehosp Disast Med 1990, 5:59-63.
7. Pepe PE, Stewart RD: Role of the physician in the prehospital setting. Ann Emerg Med 1986, 15:1480-1483.
8. Stewart RD: Medical direction in emergency medical services: The role of the physician. Emerg Med Clin North Am 1987, 5:119-132.
9. Cobb LA, Alvarez H, Copass MK: A rapid response system for out-of-hospital cardiac emergencies. Med Clin North Am 1976, 60:283-293.
10. McManus WF, Tresch DD, Darin JC: An effective prehospital emergency system. J Trauma 1977, 17:304-310.
11. Pepe PE, Fowler RL: Roots and philosophy of EMS. In 2002 National EMS Medical Directors' Course and Practicum Syllabus. Edited by Kuehl AE, Ryan JL. Largo, FL: Emergency Medical Services and Acute Care Foundation;1991;1-14. Although this is part of a 4-day course required by most municipalities for would-be or newly recruited medical directors, it is a state-of-the-art collaborative effort for the National Association of EMS Physicians that provides the historical basis for physician involvement in on-scene medical care.
12. Curka PA, Pepe PE, Ginger VF, et al.: Emergency medical services priority dispatch. Ann Emerg Med 1993, 22:1688-1695.
13. Stout J, Pepe PE, Mosesso VN: All-advanced life support versus tiered-response ambulance systems. Prehosp Emerg Care 2000;4:1-6.
14. Pepe PE, Mattox KL, Duke JH: Effect of full-time, specialized physician supervision on the success of a large, urban emergency medical services system. Crit Care Med 1993, 21:1279-1286. This is an older publication, and the methodology uses a historical control, but it provides compelling evidence and remains the source of the strongest data to date demonstrating the value of providing intensive full-time medical direction, including on-scene physician care in EMS systems.
15. McSwain NE: Overview of emergency medical care. In The Basic EMT: Comprehensive Prehospital Patient Care. Edited by McSwain NE, Paturas JL. St Louis, MO: Mosby;2001:3-5. An outstanding overview of the development of EMS systems relevant to trauma care in the United States. This article provides insight into the reasons for current system models.
16. National Academy of Sciences: Accidental Death and Disability: The Neglected Disease of Modern Society. Washington, DC: National Academy Press; 1966.
17. National Highway Safety Act, Pub L No. 89-564 (1966).
18. Emergency Medical Services System Act, Title XII of the Public Health Service Act, Pub L No. 93-154 (1973).
19. Stewart RD, Paris PM, Heller MB: Design of a resident in-field experience for an emergency medicine residency curriculum. Ann Emerg Med 1987, 16:175-179.
20. Falk JL: Medical direction of emergency medical service systems: A full-time commitment whose time has come. Crit Care Med 1993, 21:1259-1260.
21. Wydro GC, Cone DC, Davidson SJ: Legislative and regulatory description of EMS medical direction: A survey of states. Prehosp Emerg Care 1997, 1:233-237.
22. Stone RM, Seaman KG, Bissell RA: A statewide study of EMS oversight: Medical director characteristics and involvement compared with national guidelines. Prehosp Emerg Care 2000, 4:345-351. This survey demonstrates the variability of medical direction throughout the United States and the level of required involvement. Although limited by its design, it provides one of the best insights into the North American system.
23. Overton J: System design. In 2002 National EMS Medical Directors' Course and Practicum Syllabus. Edited by Kuehl AE, Ryan JL. Largo, FL: Emergency Medical Services and Acute Care Foundation;1991:54-59.
24. Garnett CF, Spoor JE: Rural systems. In Prehospital Systems and Medical Oversight, Edn. 2. Edited by Kuehl AE. St. Louis, MO: Mosby Lifeline;1994:40-46.
25. Corey E: Medical oversight: To ensure success in EMS systems, medical oversight and the medical director's role must evolve. Emergency 1995, 27:28-32.
26. Krentz MJ, Wainscott MP: Medical accountability. Emerg Med Clin North Am 1990, 8:17-32.
27. Pepe PE: Medical direction in basic life support [editorial]. Emergency 1990, 22:6.
28. Bickell WH, Wall MJ, Pepe PE, et al.: Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994, 331:1105-1109.
29. Gausche M, Lewis RJ, Stratton SJ, et al.: Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: A controlled clinical trial. JAMA 2000, 283:783-790.
30. Bickell WH, Pepe PE, Bailey ML, et al.: Randomized trial of pneumatic anti-shock garments in the prehospital management of penetrating abdominal injuries. Ann Emerg Med 1987, 16:653-658.