Abstract
The choice of allowable invasive procedures for paramedics acting on the basis of emergency relief (so called "emergency authorization") is a challenge for the EMS medical directors. In the near future, the legal foundation for standard authorization is expected. The German Medical Association has published recommendations for such measures. Still, science-based, regional choices on conferrable ...
Abstract
The choice of allowable invasive procedures for paramedics acting on the basis of emergency relief (so called "emergency authorization") is a challenge for the EMS medical directors. In the near future, the legal foundation for standard authorization is expected. The German Medical Association has published recommendations for such measures. Still, science-based, regional choices on conferrable procedures have to be made. We suggest an algorithm to systematically test whether potential medical procedures can be reasonably authorized for emergency relief by paramedics. Main criteria are medical and organizational aspects. As examples, the algorithm is performed on three measures of emergency authorization: peripheral venous puncture, needle thoracostomy for tension pneumothorax, and pharmacological analgesia. The usage of the algorithm facilitates the structured decision on procedures of emergency and standard authorization, respectively. Depending on the scenario tested, the results are considerably different. For well defined scenarios, decisions can be easily made by the algorithm, while an adaptation to local needs remains possible. The procedure does not replace special medical or organizational expertise of the decision makers.
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