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Emergency Care Change Prescribed

August 02, 1992

Do you realize that if you develop chest pain (symptomatic of) a heart attack you will be transported under the control of the paramedics to the nearest Emergency Medical System (EMS) Receiving Center, even though that hospital may be incapable of definitively handling the problem?

Do you know that if you develop abdominal pain (symptomatic of) a ruptured abdominal aortic aneurysm you will be taken to such a receiving center, even though that hospital may not even have a vascular surgeon available for immediate surgery?

The EMS was initially designed in horizontal configuration with each paramedic receiving center hospital intended to provide substantially a full range of emergency services, especially for cardiovascular services.

The paramedic system will be 20 years old this September, while the EMS was inaugurated in about 1975. Since then, medicine has changed dramatically, especially in the treatment of cardiovascular emergencies. There are only a handful of hospitals in Orange County that are capable of the definitive treatment of cardiovascular emergencies.

However, the paramedics are required to take patients with possible myocardial infarctions or ruptured abdominal aneurysms to the nearest receiving center.

The answer is simple. Cardiovascular emergency centers need to be designated in the same manner as trauma centers. The patients with such suspect problems can be diverted by the base station hospitals to the cardiovascular emergency centers and definitive treatment can be rendered by a trained team of physicians, nurses and technicians.

This realignment of the EMS is long overdue. The Board of Supervisors and the county EMS office need to be move expeditiously to effect this necessary updating.

WILLIAM M. THOMPSON, JD, MD, Huntington Beach. William Thompson is a past president of the Orange County Medical Assn. and a founding director of the Fountain Valley Hospital Trauma Center.

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