Physicians in ambulance teams in emergency medical systems

Should physicians be part of ambulance teams in emergency medical systems?

Bernd W. Böttiger: The emergency medical service (EMS) systems all around the world are organized in different ways. In many European countries and in other areas of the world, we have physicians going out to out-of-hospital cardiac arrests, and in the US and UK and some other countries, we have paramedics going out.

There was a huge discussion whether we need physicians in the out-of-hospital setting for treating cardiac arrest patients, but also for treating trauma patients and others. Since we do not have any randomized controlled trials on this important question, we have made a meta-analysis investigating all publications that are on the market addressing this question. What we found was, when you have a physician treating a patient in the out-of-hospital setting following a cardiac arrest by cardiopulmonary resuscitation, this is associated with doubling in survival.

So what we see from these data and what we recommend is, it is very useful to have physicians in the out-of-hospital setting if you are in severe conditions.