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A study from Sheffield reports that paramedics with appropriate training can assess and treat older people with minor illness or injury in the community as safely as the emergency medical services and the emergency department. Paramedic decisions about the need for admission did not lead to a significant increase in unplanned emergency department attendances and there was no difference in the level of care they provided (Acad Emerg Med 2008;15:607–12).
PUBLIC ACCESS DEFIBRILLATION
Resuscitation attempts are more successful when automated external defibrillators (AEDs) are used on-site compared to when mobile AEDs are used by lay community first responders. This is the finding of the National Defibrillator Programme promoting public access defibrillation in the UK, which analysed results from 1530 resuscitation attempts. Differences in outcomes appear to reflect many factors, including whether the arrest was witnessed and bystander cardiopulmonary resuscitation performed, the nature of the presenting rhythm, the age and comorbidities of the patient and the time delay between collapse and the start of cardiopulmonary resuscitation or defibrillation. This paper will help to shape future prehospital resuscitation …