Effect of standing orders on field times

Area of Science:

• Emergency Medicine
• Health Services Research

Background:

• Paramedics in a California EMS system shifted to emergency standing orders due to base hospital discontinuation.
• Medical control was later resumed under limited standing orders for specific interventions.

Purpose of the Study:

• To compare prehospital care and at-scene times before and after the implementation of standing orders.
• To evaluate the impact of different standing order protocols on EMS response times.

Main Methods:

• Retrospective study design comparing three groups: control (no standing orders), emergency standing orders, and limited standing orders.
• Analysis of at-scene times and total prehospital care times.

Main Results:

• Significant reductions in total prehospital care times were observed with both emergency and limited standing orders compared to the control group (P < .01).
• Significant reductions in at-scene times were also noted in the standing order groups compared to the control group (P < .01).

Conclusions:

• The use of standing orders by paramedics can lead to more efficient prehospital care.
• Extensive base hospital contact may not be necessary for all advanced life support calls and can impact EMS system efficiency.