This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

J. Philip Smith, MD
Emergency Medical Service City and County of San Francisco Department of Public Health

B. I. Bodai, MD
University of California at Davis Sacramento

JAMA. 1986;255(5):612.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Prehospital care evolved from the original model of a "mobile cardiac care unit." Initially, only a defibrillator was present on the ambulance. Now in California over 40 different IV medications can be employed for the treatment of multiple medical and surgical emergencies.

A fundamental assumption has been made that what can be treated in the hospital will respond to prehospital interventions. The above letters reflect that hypothesis. However, there is little proof that this assumption is valid.

We believe prehospital care is uniquely different from hospitalbased treatment. The prehospital rescuers are limited to only four hands. Each therapeutic intervention must be performed in sequence rather than in parallel, as is often the case in the emergency department. In addition, with a multitude of emergencies to treat, the paramedics are required to become diagnosticians, yet their diagnostic equipment consists of only a stethoscope, a sphygmomanometer, and an electrocardiographic monitor. . . . [Full Text PDF of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?