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A new faculty and journal are encouraging research and better services
Many of the people who die of trauma, heart attacks, or stroke die within the first hour. Many do not reach hospital. People have thus long recognised the need to improve the emergency services offered to patients before they reach hospital. But research on what happens at that critical time is hard to do. Many questions remain about who should offer the care and how it can best be offered. In an attempt to encourage research into prehospital emergency care and to develop the services offered, the Royal College of Surgeons of Edinburgh has established a multidisciplinary faculty of prehospital care. Now BASICS (British Association for Immediate Care) and the BMJ Publishing Group are launching a new journal-Pre-hospital Emergency Care Journal. *
BASICS was begun by Ken Easton in 1966 after he had seen serious road accidents poorly managed. It now comprises 1700 doctors around Britain, most of them general practitioners, who are prepared to offer immediate care. Ambulance staff have meanwhile greatly improved their skills. Some ambulance services believe that prehospital care belongs to paramedics, 1 but there is evidence that results are better in a rural setting if a trained general practitioner is called. 2
Arguments continue over who is the best person to provide care, and research is limited. Defibrillators undoubtedly improve the outcome from cardiac arrest, 3 and first aiders can be trained to use them. 4 The advantages of a paramedic (who can intubate and give drugs) over a technician (who can defibrillate) have been challenged. 5 Trained doctors can do all those things. Doctors also have an advantage...