Review of: Soares-Oliveira M, Egipto P, Costa I, Cunha-Ribeiro LM, et al: Emergency motorcycle: has it a place in a medical emergency system? American Journal of Emergency Medicine 25(6): 620-622, 2007.
The utility of non-traditional delivery of EMS such as bike medics, horse-mounted patrols, or in this case medical emergency motorcycle (MEM) has been considered in many systems and is used frequently in the care for large gatherings.
This study, performed in Portugal was designed to examine the use of their MEM program over a period of time. It was a retrospective study of the care records generated from runs where an EMT-Basic with an AED on a motorcycle was dispatched for high priority calls.
There were 1,972 calls. The average time of MEM arrival was 4.4 +/- 2.5 minutes. The most common intervention was administration of oxygen (n = 626), immobilization (n = 118), and control of hemorrhage (n = 101). In 63% of cases, MEM arrived before other emergency vehicles. In 355 cases (18%), there was no need for transport.
The most interesting thing about this article is the conclusion where they state, “We propose that it should be dispatched mainly in the following situations: true life-threatening cases and uncertain need for an ambulance.”
In their system HEMS was activated for all calls where both ALS and BLS ambulance resources were simultaneously mobilized. This represents the highest priority calls received by 9-1-1. Despite this, 18% of the response was felt not to require an ambulance transport. This is more an incrimination of their emergency medical dispatch system than it is a reasonable conclusion of the role of MEM. If a system receives a call that is felt not to warrant an ambulance there is no reason to send any type of red lights and sirens response.
Clearly, there is a role for MEM. To move efficiently through city traffic and not over tax the use of more cumbersome and slower ambulances it is possible to get a trained EMS provider at the patient s side to make a rapid determination as to the seriousness of the call and more effectively manage the ultimate response.