NCPA - National Center for Policy Analysis


March 8, 2005

Cities with larger paramedic staffs do not always have higher cardiac arrest survival rates, according to USA Today.

Large cities have debated whether to staff each fire engine with a paramedic in order to ensure that specially trained medical staff is on the scene when a victim suffers cardiac arrest. However, cities with fewer paramedics have remarkable survival rates.

For example:

  • In examining medical data on 12 of the nation's largest cities, USA Today found that victims of cardiac arrest are more likely to be revived in cities that spend fewer taxpayer dollars on paramedics.
  • Seattle has the highest survival rate in the nation at 45 percent, yet has a low paramedics ratio of only 1.28 per 10,000 residents; Boston, with the second-highest survival rate of 40 percent, has the lowest paramedics ratio of only .86 per 10,000 residents.
  • In Tulsa, only 5 of the city's 30 fire engines have a paramedic on board, yet the survival rate for cardiac arrest is above the national average at 26 percent.
  • Conversely, Nashville's paramedic ratio is 3.33 per 10,000, yet its survival rate is only 8 percent; likewise, Omaha has the highest paramedic ratio in the nation at 4.70 per 10,000, but has only a 16 percent survival rate.

In cities such as Seattle, Boston and Tulsa, firefighters are trained in rapid response and basic medical care, eliminating the need for a paramedic on every fire engine. Paramedic teams will then arrive a few minutes later to provide more specialized care.

Observers note that since most 911 calls are non-emergencies, having a large paramedic staff means each one is doing fewer emergency procedures, therefore it becomes difficult for cities to monitor their training and skill levels.

Although there is no scientific evidence that having a paramedic on each fire engine saves lives, politicians and the public want them.

Source: Robert Davis, "Paramedics Not Always the Saviors of Cardiac-Arrest Patients," USA Today, March 1, 2005.

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