Annals of emergency medicine
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Review Comparative Study
The complexity of comparing different EMS systems--a survey of EMS systems in Europe.
In Europe, emergency medical care has developed since the Middle Ages in each country, even within regions of a country, resulting in a patchwork of definitions, legislations, and systems. As a consequence, emergency medical care was implemented differently according to sociocultural, geographic, political, and religious differences between and within individual European countries. The objective of this survey was to describe the emergency medical services (EMS) systems in place throughout Europe, the type and qualification of the personnel, citizen-CPR knowledge, and experiences with automated external defibrillator programs. ⋯ To describe the EMS system, a uniform nomenclature is required. The Utstein "template" style could be proposed as the guideline to describe individual systems. The European Resuscitation Council could contribute in coordinating and standardizing the various aspects of emergency medical care in Europe, with detailed registration, medical coordination, and medical regulation being the principal working rules.
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Patients who suffer an in-hospital cardiac arrest represent a neglected and underutilized resource for resuscitation research. There exists an unwritten, but widely held, belief among resuscitation researchers that the in-hospital arrest population is unsuitable for resuscitation research because it is composed mostly of patients whose cardiac arrest is the terminal event of a fatal illness. Despite the large numbers of hospitalized patients on whom cardiac resuscitation is attempted each year, there are few reports and even less true research devoted to this clinical problem. This article, which is intended to be provocative, reviews and summarizes the existing literature on in-hospital resuscitation from cardiac arrest, considers the advantages of resuscitation research in this setting, and concludes with a challenge to resuscitation researchers.