INJURY PREVENTION - IS THERE A ROLE FOR OUT-OF-HOSPITAL EMERGENCY MEDICAL-SERVICES

Objective: To review the literature for options for integrating injury prevention into the role of out-of-hospital emergency medical service s (EMS). Data Sources: Computerized searches of the English-language l iterature from 1966 through 1994 were conducted using the MEDLINE and National Association of EMS Physicians (NAEMSP) databases. These were supplemented by hand searches of pertinent journals not indexed on MED LINE or by NAEMSP and the reference lists of retrieved articles. Key w ords searched included emergency medical services, accident, injury, p revention, and safety. Article Selection: The review included all arti cles that described the experience of EMS organizations or individuals providing primary injury prevention (PIP) services or that proposed E MS PIP activities. Synthesis: PIP EMS experiences and PIP activities p roposed for EMS included: preventing injuries in EMS providers, servin g as role models, identifying persons at risk for injury, providing pr evention counseling, collecting injury data, surveying residences and institutions for injury risks and hazards, conducting educational prog rams and media campaigns, and advocating legislative changes that prom ote injury prevention. Few studies have evaluated the effectiveness of EMS PIP activities. Conclusion: As changes in the market compel healt h care systems to focus more on prevention, EMS organizations and indi vidual providers may be assuming new injury prevention roles. Some EMS systems in many parts of the country have incorporated PIP into their work. It is necessary, however, to determine which PIP roles are effe ctive and how they will be supported.