43 - Emergency medical services systems and out-of-hospital cardiac arrest

Summary

Introduction

Emergency Medical Services (EMS) constitute a unique component of health care in the prehospital setting. Prehospital EMS systems are commonly understood as the resources used for planning and providing medical care for patients who experience an unpredicted need for emergency or urgent medical care outside a hospital. The EMS system 's primary role is to provide care for patients whose lives are at immediate or imminent risk. In the beginning of organized prehospital care, most emergencies were of traumatic origin but in the last decades this has changed to include medical problems. In 2002 at the conference of the European Resuscitation Council in Florence the First Hour Quintet (FHQ) was defined, a set of five major medical problems of prehospital care on which EMS can have a significant impact on the outcome; these are:

• out-of-hospital cardiac arrest (OHCA)

• severe respiratory difficulties

• severe trauma

• chest pain, including acute coronary syndrome

• stroke.

Together these conditions areamongthe four leading causes of death in the European Union (EU). Cardiovascular problems, cancer, externalcauses,andrespiratorydiseases represent the top four leading causes of death and morbidity: 80% of all deaths are attributable to these common causes. Cardiovascular disease (CVD) is the number one cause of death in all EU countries, resulting in 4 million deaths per year inEuropeor 1.5 million in theEU,respectively.CVDalso accounts for the largest amount of years of life lost by early death in Europe and in the European Union, contributing significantly to the escalating costs of health care. Coronary HeartDisease (CHD) is the most important cause of death in the adult population, comprising 55% of all CVD deaths.