Comparing emergency medical service systems-A project of the European Emergency Data (EED) Project

Aim: The aim of this prospective study was the comparison of four emergency medical service (EMS) systems emergency physician (EP) and paramedic (PM) based and the impact of advanced live support (ALS) on patients status in preclinical care. Methods: The EMS systems of Bonn (GER, EP), Cantabria (ESP, EP), Coventry (UK, PM) and Richmond (US, PM) were analysed in relation to quality of structure, process and performance when first diagnosis on scene was cardiac arrest (OHCA), chest pain or dyspnoea. Data were collected prospectively between 01.01.2001 and 31.12.2004 for at least 12 month. Results: Over all 6277 patients were included in this study. The rate of drug therapy was highest in the EP-based systems Bonn and Cantabria. Pain relief was more effective in Bonn in patients with severe chest pain. In the group of patients with chest pain and tachycardia >= 120 beats/min, the heart rate was reduced most effective by the EP-systems. In patients with dyspnoea and SpO