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Emerg Med J 19:155-159 doi:10.1136/emj.19.2.155
  • Prehospital care

Delphi type methodology to develop consensus on the future design of EMS systems in the United Kingdom

Table 2

Final opinions of respondents to the second questionnaire

Median score (MS) Interquartile range (IQR)
0=Strongly disagree 9=Strongly agree.
Dispatch criteria
Paramedic (ALS) unit sent to all calls 0 1
ALS unit to all category A and B calls only 4 4.5
ALS unit to all category A and selected category B calls 9 2
Technicians with automated external defibrillator (T-AED) unit to selected category A and B calls and all C calls 8 3
A first responder unit ( with BLS skills only) can be sent to selected category C calls 4 3
A first responder unit to all category C calls 0 3
An assumed or confirmed cardiac arrest should receive an automatic additional response from other units 7 3.5
Transportation criteria
After assessment by an ALS unit, certain category B patients can be handed over to a T-AED unit for transportation to hospital 8 2
After assessment by an ALS unit , certain category B and all category C patients can be handed over to a T-AED unit or first responder unit for transportation to hospital 8 2
Development of advanced skills for paramedics
A number of paramedics within a system should have additional skills to perform endotracheal intubation using anaesthetic agents 7 4
Paramedics should be taught to carry out and interpret 12 lead ECGs for patients with chest pain 9 4
Paramedics should be taught to carry out thrombolysis for patients with confirmed acute myocardial infarction on a 12 lead ECG 7 4
Development of a first responder system
A first responder system should be trained and fully integrated into an EMS system 9 2
Should be employed solely by the ambulance service 1 7
Should be made up partly of members of the voluntary services 5 3.5
Should include members of the police service with automated external defibrillators (AEDs) 6 4
Should include members of the Fire Service with AEDs 6 4.5
Should include trained members of the local community 8 4

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