Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained?

Acta Anaesthesiol Scand. 2002 Aug;46(7):771-8. doi: 10.1034/j.1399-6576.2002.460703.x.


Background: The benefit of prehospital advanced life support (ALS) is disputed, as is the prehospital use of specially trained, hospital-based physicians. The purpose of the study was to assess the health benefit from an anesthesiologist-manned prehospital emergency medical service (EMS), and to separate the benefit of the anesthesiologist from that of rapid transport.

Methods: The anesthesiologist-manned helicopter and rapid response car service at Rogaland Central Hospital assisted 1106 patients at the scene during the 18-month study period. Two expert panels assessed patients with a potential health benefit for life years gained (LYG) using a modified Delphi technique. The probability of survival as a result of the studied EMS was multiplied by the life expectancy of each patient. The benefit was attributed either to the anesthesiologist, the rapid transport or a combination of both.

Results: The expert panels estimated a benefit of 504 LYG in 74 patients (7% of the total study population), with a median age of 54 years (range 0-88). The cause of the emergency was cardiac diseases (including cardiac arrest) in 61% of the 74 patients, trauma in 19%, and cardio-respiratory failure as a result of other conditions in 20%. The LYG were equally divided between air and ground missions, and the majority (88%) were attributed solely to ALS by the anesthesiologist.

Conclusion: The expert panels found LYG in every 14th patient assisted by this anesthesiologist-manned prehospital EMS. There was no difference in LYG between the helicopter and the rapid response car missions. The role of the anesthesiologist was crucial for health benefits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesiology*
  • Child
  • Child, Preschool
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Heart Arrest / mortality
  • Heart Arrest / therapy
  • Heart Diseases / mortality
  • Heart Diseases / therapy
  • Humans
  • Infant
  • Life Support Care*
  • Male
  • Middle Aged
  • Quality-Adjusted Life Years
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / therapy
  • Survival Rate
  • Wounds and Injuries / mortality
  • Wounds and Injuries / therapy