February 2004 Vital Signs

Former Paramedic Named ACEP President-Elect

Robert Suter, DO, MHA, FACEP, emergency department medical director at Spring Branch Medical Center in Houston, TX, and a partner in Greater Houston Emergency Physicians, has been named president-elect of the American College of Emergency Physicians (ACEP). Suter is the first physician to serve in this role who has worked full time as an EMT and paramedic.

Suter's EMS career began as a teenager when he volunteered on a search and rescue squad in St. Charles, MO. He then worked as an EMT and later as a paramedic in St. Charles and St. Louis Counties, where he worked part time until he graduated from medical school. He completed his residency in emergency medicine at the Joint Military Medical Centers in San Antonio in 1993, was elected to ACEP's Board of Directors in 1999, and was re-elected in 2002. In 1993, Dr. Suter was appointed to work with NHTSA as the physician co-chair of the group that developed the EMS Agenda for the Future—a document that lays out basic strategies for ensuring the future viability and community value of EMS systems.

Suter is confident his new position will strengthen ACEP's relationship with prehospital providers. "ACEP has been dedicated to sustaining an excellent relationship with EMS personnel and EMS organizations, but there is always room for improvement," he says.

"For example, ACEP is the originator of EMS Week and has always put a lot of resources into sponsoring it. They are very positive toward EMS. I hope my presidency will reinforce that and personalize it, so the EMS community can see that one of them rose to the top of the organization."

Many of ACEP's objectives include areas of great importance to prehospital providers, says Suter. Some of these include: professional liability; ED overcrowding that results in ambulance diversions; quality and patient safety; and reducing errors in emergency care. "Those are objectives that should hit home in the EMS community and things we can work on together," he says. "They are areas that, in my position as president, I will look for EMS input on."

—MN

PAD Trial Shows Benefit to Public-Access Defibrillation

Public-access defibrillation makes sense on an intuitive basis—placing defibrillators in public venues and training people to use them seems like it should save lives. Now the results of the largest-ever study of the issue bear that out.

Installing AEDs at public sites and training volunteers to perform CPR and use them roughly doubles the number of victims who survive sudden cardiac arrest episodes in such environments, according to a National Heart, Lung and Blood Institute-funded study presented in November at the American Heart Association's Scientific Sessions in Orlando, FL.

For the Public Access Defibrillation (PAD) Trial, AEDs were placed at nearly 1,000 North American community sites (apartment complexes, shopping centers, office buildings, sports arenas) identified as having the potential for a large number of cardiac arrests, and approximately 20,000 volunteers were trained in CPR or CPR and using an AED. Subsequent SCA victims at these sites received either CPR and AED treatment on-scene, or just CPR, before the arrival of trained medical responders. They were then tracked for survival to hospital discharge. Of the CPR/AED cohort, 29 survived to that point. Of the CPR-only recipients, 15 did.

"This study shows that lives can be saved by training community volunteers to use external defibrillators," acting NHLBI Director Barbara Alving, MD, declared.

In both groups, a majority of victims were white men in their late 60s/early 70s. Increased survival was seen more in truly public sites than in residential settings, where the AEDs did not seem to make as much difference. There were no major injuries incurred or safety issues for the volunteers, who received 2-4 hours of initial training and, in many cases, refresher training as the study progressed.