Table 2.
Comparison of EMS clinical performance indicators.
| US clinical performance indicators* | ||||||
|---|---|---|---|---|---|---|
| Clinical condition | ST Elevation Myocardial infarction (STEMI) | Pulmonary Edema | Asthma | Seizure | Trauma | Cardiac arrest |
| Indicators or bundle elements | (1) Aspirin (2) 12 lead Electrocardio-graph (ECG) (3) Direct transport to percutaneous cardiac intervention (PCI) interval from ECG to balloon <90 minutes |
(1) Nitroglycerin (2) Noninvasive positive pressure ventilation |
(1) β 2 agonist administration | (1) Blood Sugar measurement (2) Administration of a benzodiazepine |
(1) Entrapment time <10 minutes (2) Direct transport to trauma for patients meeting criteria |
(1) Response interval <5 min for basic CPR and Automated external defibrillators (AEDs) |
|
| ||||||
| Outcome | NNT = 15 Harm avoided: A stroke, 2nd myocardial infarction, or death |
NNT = 6 Harm avoided: need for an endotracheal intubation |
Not Specified | NNT = 4 Harm avoided: persistent seizure activity |
NNT = 3 or 11 depending on criteria used Harm avoided: one death | NNT = 8 Harm avoided: one death |
|
| ||||||
| UK clinical performance indicators# | ||||||
| Clinical condition | STEMI | Stroke/TIA | Asthma | Hypoglycemia | Trauma | Cardiac arrest |
|
| ||||||
| Indicators or bundle elements | (1) Aspirin (2) Nitroglycerin (3) Recording pain score (before and after treatment) (4) Pain medication (5) Transfer targets for thrombolysis/PCI |
(1) Recording of Face Arm Speech Test (FAST) (2) Recording of blood sugar (3) Recording of blood pressure |
(1) Recording of respiratory rate (2) Recording of Peak Expiratory Flow Rate (PEFR) (3) Recording of SpO2 (4) β 2 agonist (5) Oxygen |
(1) Recording of blood glucose before treatment (2) Recording of blood glucose after treatment (3) Recording treatment (4) Direct referral to appropriate health professional |
Pilot indicators available only for patients with severe trauma (Glasgow Coma Score, GCS < 8) (1) Recording of blood pressure (2) Recording of respiratory rate (3) Recording of SpO2 (4) Recording of pupil reaction |
(1) Return of Spontaneous circulation (ROSC) on arrival to hospital (2) Presence of defibrillator on scene (3) ALS provider in attendance (4) Call to scene response ≤4 min |
|
| ||||||
| Outcome | Improved assessment and management of STEMI with increased survival | Improved assessment and management of stroke | Improved assessment and management of asthma | Improved assessment and management of hypoglycemia | Not specified | Improved response to and survival from cardiac arrest |