More on Field TOR - @ JEMS.com


More on Field TOR


 
 

Keith Wesley | | Thursday, June 28, 2007


Morrison LJ, Visentin LM, Vermeulen M: "Inter-rater reliability and comfort in the application of a basic life support termination of resuscitation clinical prediction rule for out of hospital cardiac arrest." Resuscitation. 74(1):150 157, 2007.

The Science:

This is a follow-up study of one I reviewed in August, in "Terminating Resuscitation in Out-of-Hospital Cardiac Arrest." That study, published in the New England Journal of Medicine, validated a field termination of resuscitation (TOR) algorhythm for EMS. This study measured whether or not the paramedic and the EMT applied the protocol correctly, how comfortable they were in its conclusion, and how well they agreed on its recommendation to terminate resuscitation.

Paramedics and EMTs applied the rule with equal perfection and were in agreement 88% of the time.

The study also found that when both the paramedic and the EMT applied the rule correctly, they were significantly more likely to feel completely comfortable with its recommendations. When not applied correctly, they were more likely to feel uncomfortable with the recommendations.

The Street:

We have already discussed the TOR rule they are proposing. What this study does is show that your providers must feel comfortable in using it if you expect it to be applied correctly. In fact, if EMS providers feel uncomfortable using it they re probably not applying it correctly. This requires better education and training, and perhaps it should be used as a marker to know when to contact medical control for advice.

Great debate over TOR in cardiac arrest continues, with some service directors taking a draconian approach that requires transport because no transport means no reimbursement. While clearly a financial issue is involved in not transporting cardiac arrests, these types of calls represent less than 5% of all calls and do not represent a huge fiscal impact.. The cost of futile resuscitation to the patient and society in general, not only in healthcare costs but in emotional turmoil, is tremendous.

We must continue to find what helps the most people with the limited resources we have. The use of field TOR is just one step toward this goal.




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Industry News

What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

Philadelphia Fire Department Apologizes for Medic’s Jab at Police

Union head calls photos a slap in the face of officers.
Watch It >


Multimedia Thumb

D.C. Fire and EMS Crews Blame New Technology for Patient’s Death

Delayed response blamed on recurring dispatch problems.
Watch It >


Multimedia Thumb

Suspect Steals, Crashes Maryland Ambulance

One killed, others injured in Prince George’s County crash.
Watch It >


Multimedia Thumb

Truck Strikes Pedestrians in Scotland

Six killed in downtown Glasgow.
More >


Multimedia Thumb

Tennessee Trench Rescue

Worker pulled from Roane County worksite.
More >


Multimedia Thumb

Time’s Ebola Firefighters

Doctors, nurses and others saluted for fighting virus.
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


More Product Videos >