Variations in equipment on UK front line ambulances (2000;4; 126-31)

The range of medical equipment carried by front line ambulances varies considerably across the UK, finds a study in Pre-Hospital Immediate Care.

A survey of all 39 UK ambulance services showed that while they all carried basic equipment, there were significant discrepancies and areas of poor provision. Only one in five routinely carried nasopharyngeal airways, used to deliver oxygen to patients with facial muscle spasm. And only 13 per cent carried an alternative to the tube used to ventilate the windpipe, the endotracheal tube.

It is widely accepted that high concentrations of oxygen helps to save the lives of people who are severely injured, and all ambulance services have this capacity. But a quarter of the services did not carry the appropriate oxygen mask to achieve this. Traction splints are not uniformly used, with almost a third of services not carrying them and almost four out of 10 services still rely on inflatable splints despite concerns that they restrict blood circulation. And only a third of ambulance services authorised their staff to decompress tension pneumothorax-where air is trapped in the chest, which can kill if not released-despite having the necessary equipment.

The role of paramedics has expanded, say the authors, so it is not surprising that the range of equipment in front line ambulances has increased. But the significant variations will affect the treatment, and possibly survival, of patients, they say. And certain pieces of equipment should not be regarded as optional.

Contact:

Mr Keith Porter, Selly Oak Hospital, Birmingham