UBC Theses and Dissertations
Out of hospital cardiac arrest in Saskatoon : an assessment of the emergency medical system Medd, Lorna May
The question addressed in this thesis is should the City of Saskatoon, Saskatchewan develop an emergency medical system (EMS) specifically designed to deal with out-of-hospital cardiac arrest? In order to answer this question, a series of subsidiary questions must be dealt with, as follows: 1. Can an EMS provide real health gains in terms of decreased morbidity and mortality from cardiac arrest? 2. What are the components of an EMS that are required to achieve this decrease in morbidity and mortality? 3. Is the community in question typical for cardiac arrest in terms of sociodemographic, morbidity, and mortality patterns, or sufficiently different from population data in the published literature that the EMS will be required to accommodate the differences? 4. How important a cause of morbidity and mortality is cardiac arrest, and will it become a greater or a lesser problem in the next decade? 5. Is the establishment of such a service an effective way of reducing morbidity and mortality from cardiac arrest, or are there ways of dealing with cardiac arrest that will have more impact? The province of Saskatchewan and the City of Saskatoon are attempting to deal with these issues in order to develop long range plans for an effective and affordable ambulance service for both the province and the larger cities. The causes and extent of sudden cardiac death in Canada and in Saskatoon are described from reports in the existing scientific literature and local death registry data. The epidemiology of coronary heart disease (CHD) and the impact on mortality from CHD by an array of primary, secondary and tertiary preventive interventions are presented in order to provide a context from which the most appropriate approach for Saskatoon may be chosen. Highly developed EMS1s in North America are described from published reports. Their impact on mortality is analysed, with particular attention paid to recent developments which appear most promising for Saskatoon and area. Features of the system which is currently operating in Saskatoon are drawn from data in the annual reports of the Saskatoon and Area Ambulance Board from 1980 to 1983. Recommendations based on the compiled data are specific to Saskatoon and area and are related to the needs, existing services and structures, and available resources in that community.