J Korean Soc Emerg Med.  2015 Oct;26(5):437-442. 10.0000/jksem.2015.26.5.437.

Agreement of Medical Directors for Indirect Medical Oversight on Prehospital Care

• Park PK
• Kim SH
• Lee WC
• Kim MH

• KMID: 2191705
• DOI: http://doi.org/10.0000/jksem.2015.26.5.437

Abstract

PURPOSE
The medical director is a core factor in maintaining high quality emergency medical services. This study was conducted to evaluate the agreement of medical oversight for prehospital emergency care between medical directors.
METHODS
Two medical directors assessed the same 119 rescue run sheets with 28 cases of cardiac arrest, 12 cases of withhold or interruption of cardiopulmonary resuscitation (CPR), and 22 cases of severe trauma. The assessment for prehospital evaluation of patients, treatment and medical direction was compared between the two medical directors,
RESULTS
The use of an automated external defibrillator in cardiac arrest that was assessed as appropriate was 17/28, 22/28, respectively. In assessing for withhold or interruption of CPR, one medical director assessed as all appropriate for checking for pulse, respiration, and mental status regardless of recording on a 119 rescue runsheet, but the other medical director as inappropriate if there are no records on the runsheet. The assessment for airway treatment, aid for circulation, appropriateness of treatment for trauma, and appropriateness of medical direction in severe trauma differed between the two medical directors.
CONCLUSION
Some differences were found in assessing the prehospital care between medical directors. A quality program for improving agreement between medical directors is necessary and the protocol for prehospital care should be modified according to the local situation.

Keyword

Emergency medical services; Prehospital emergency care; Quality control

MeSH Terms

Cardiopulmonary Resuscitation
Defibrillators
Emergency Medical Services
Heart Arrest
Humans
Physician Executives*
Quality Control
Respiration