January 2005 EMS Wire Service

AHA, ILCOR Seek Comments on CPR/ECC Studies

The American Heart Association (AHA) and International Liaison Committee on Resuscitation (ILCOR) are seeking public comments to help them develop an international consensus document and treatment recommendations for CPR and emergency cardiovascular care.

Through January 23, the organizations will post more than 250 scientific evidence evaluation worksheets for review at www.c2005.org. Each worksheet addresses a specific resuscitation topic evaluated from a scientific perspective; the authors review and analyze evidence underlying such issues as the optimal rate and ratio of chest compressions in children and the effect of defibrillation waveforms on survival of VF cardiac arrest.

The comment process will culminate with the International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations Conference in Dallas, January 23–30. There, subject-matter experts will formulate consensus positions on CPR/ECC issues. For more information, see www.americanheart.org/cpr.

—American Heart Association

Commercial Draws Ire of NAEMT Leaders

Leaders of the National Association of Emergency Medical Technicians (NAEMT) issued a statement condemning a TV commercial they said “insults the professionalism of paramedics and [EMTs] and discourages people from calling for lifesaving help in the event of an emergency.”

The commercial, for Blue Cross/Blue Shield, depicts an ambulance stopping at an ATM. A patient with a broken leg then emerges from the vehicle and withdraws money to cover medical costs. The paramedics, according to the NAEMT, are portrayed as “uncaring, bored and concerned only about money.”

“This commercial…insults the hard-earned professionalism of [EMS] workers everywhere,” NAEMT president John Roquemore said in the statement. The NAEMT has requested the commercial not be aired and that Blue Cross/Blue Shield apologize to EMS professionals.

—NAEMT

ED Overcrowding Leads to Clotbusting Delays

A new study in the Annals of Emergency Medicine suggests that emergency department overcrowding leads to longer delays before heart attack patients receive lifesaving clotbusting medications.

Heart attack patients seen in crowded EDs were 40% more likely to experience major delays—defined as door-to-needle times of 60 minutes or more—than were similar patients seen in less-crowded EDs, the study showed. The former group showed a median door-to-needle time 5.8 minutes longer than the latter.

With heart attacks, every minute counts, and the longer it takes until thrombolytics are administered, the higher the mortality.

The study examined more than 3,400 suspected heart attack patients seen at 25 Ontario hospital emergency departments over three years. The hospitals had formed 10 ambulance networks that operated uniform ambulance-diversion systems. Each also participated in a registry that allowed researchers to identify patients who received clotbusters.

—American College of Emergency Physicians

FAA Panel Criticizes Airport Fire Standards

Airport fire departments operate under standards that are inadequate to save lives and inhibit their fighting fires that accompany plane crashes, a government panel concluded in October.

The panel, convened by the Federal Aviation Administration (FAA) three years ago, said that many airports should be required to have fire trucks and use firefighting foam that’s more flame-retardant. Airport FDs must also reach crashed aircraft faster, they said.

The Airport Rescue and Firefighting Requirements Working Group was commissioned following several cases in which the National Transportation Safety Board (NTSB) cited faulty responses by airport fire departments as contributing to passenger deaths. The group included firefighters, airport officials and members of aviation unions. Its findings do not carry any legal mandate, but may influence FAA policy. Any changes to pertinent federal standards would have to be approved by the Bush administration.

—USA Today

First ACEP President Killed in Car Crash

John G. Wiegenstein, MD, the first president of the American College of Emer-gency Physicians (ACEP), was killed in a car crash on October 28 near Naples, FL. He was 74.

Wiegenstein, along with seven other emergency docs, founded ACEP in 1968. In addition to serving as its first president, he also served as president of the American Board of Emergency Medicine. In 2001, the American Medical Association awarded him its highest honor, the Distinguished Service Award.

In other news, Robert E. Suter, DO, MHA, FACEP, became ACEP’s new president. The organization also presented its John G. Wiegenstein Award for Outstand-ing Leadership to another past president, Charlotte, NC, emergency physician Dr. Robert Schafermeyer. Schafermeyer co-founded ACEP’s Pediatric Emergency Medicine section in the early ’90s and, during a presidency that began in 2000, appointed a task force to examine the issue of emergency department overcrowding.

—American College of Emergency Physicians

Can Pseudoephedrine Cause Heart Attacks?

The common over-the-counter decongestant pseudoephedrine can cause heart attacks even in young, seemingly healthy individuals, a case report in the Annals of Emergency Medicine suggests.

The 32-year-old subject of the report, authors say, is at least the fifth young, healthy pseudoephedrine user to suffer a heart attack. He had taken the recommended dosage of an over-the-counter cold medication containing the substance.

Pseudoephedrine is similar to ephedrine, the key ingredient in dietary supplements recently banned by the Food and Drug Administration because of their links to heart attacks, stroke and sudden death. Both substances modify heart activity in response to adrenaline.

—American College of Emergency Physicians