BMJ 1995;311:509 (19 August)

Letters

Studying only admissions is a source of potential bias

EDITOR,--U M Guly and colleagues state that their study, which claims to show that "paramedics and technicians are equally successful at managing cardiac arrest outside hospital," does not "diminish the role of paramedics."1 Yet the paragraph about their paper in This week in BMJ concludes that such patients "are best treated" by technicians and calls into question the requirement of having a paramedic in every emergency ambulance. We do not believe that such a conclusion can be safely drawn from the data presented.

The methodology gives rise to several sources of bias. Information is presented for those patients taken to the emergency department and not for all patients sustaining cardiac arrests in the community. In our series, based on telephone interviews with ambulance staff, 30% of all patients were certified dead at the scene, and for every three cases in which resuscitation was attempted there were two cases in which . . . [Full text of this article]


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Relevant Article

Paramedics and technicians are equally successful at managing cardiac arrest outside hospital
U M Guly, R G Mitchell, R Cook, D J Steedman, and C E Robertson
BMJ 1995 310: 1091-1094. [Abstract] [Full Text]

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