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Do First-Responders offer a placebo effect?


brentoli

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Ok I am going for the trifecta in quality topics here.

Does the arrival of first responders work as a placebo effect? Not limited to CFR's but EMT-B's, EMT-P's, FD, and PD. Does the arrival of someone on scene without the means to transport do any good for the paitent? We all have seen stressed out family and patients calm down on the arrival of someone "official," of course the oppisote happens as well. Does the arrival of someone on the scene provide any help to paitents though? Does the 5 min of decreased stress and anxiety in the MI paitent have any beneficial effect?

Don't take this as a BLS/ALS debate its not. Your first responder could be a QRV medic with transporting unit 10 min out (NJ anyone?).

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Brent,

regardless of skill level, capabilities etc. in many cases the sight of a person in uniform will begin to alleviate the persons fears.

Yes this is a placebo effect, yes this is positive.

The other thing to remember here is that the vast majority of calls are BLS calls, where the primary roll, & evein in ALS protocols the first thing you do is ABC, so placaebo or not, everyone, from first responder to Doctor will still be able to do the same thing, maintain an Airway, Ensure airmovment is happening & if not, Breath for them & commence commpressions if Circulation has ceased.

Phil

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Does the arrival of first responders work as a placebo effect?

No..I don't think so. I would think if the person was sick and needed transport, the arrival of the ambulance may relieve some anxiety. Simply having a person there with no ability to transport the patient, official or not, would not do this. Most individuals that are truly sick or injured don't much care who is there, as long as they can expedite their arrival to the hospital, even though treatment may be started in advance.

This is not to say that an ALS first response is not great, but I don't think a placebo effect is in play here.

As usual..just my opinion :wink:

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I agree with CCMedoc. A majority of the public does not see us as the ones who are going to fix their issues. No matter how many cool "skills" and toys we have most of the public sees the hospital as their goal. The Doctor is going to be their savior not us. I am not saying this is the way it is, it's just how Joe and Jane Public see it. They want to see a Doctor not a FR or Paramedics.

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I agree with CCMedoc. A majority of the public does not see us as the ones who are going to fix their issues. No matter how many cool "skills" and toys we have most of the public sees the hospital as their goal. The Doctor is going to be their savior not us. I am not saying this is the way it is, it's just how Joe and Jane Public see it. They want to see a Doctor not a FR or Paramedics.

While the goal is hospitalisation, the mind is a powerful thing & I have witnessed the relief in people when we walk through the door.

In a pt having an AMI, if this relieves anxiety & lowers their BP even a small amount, isnt that a good thing? Coupled with the drug therapies that are on offer, we can achieve fantastic results, pre hospital, but these pts need hospitalisation & further more difinitive treatment.

To undervalue the knowledge, & benefits of walking onto a scene & simply speaking to the patient, calming them is, in my humble opinion, more beneficial than drug therapies.

Phil

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Here in the UK, we have Rapid Response Paramedics in Cars which provide an initial response to be backed up by BLS/ ALS crews. This is used extensively to meet government set response times. In amongst my normal shifts in a regular Ambulance, I work RRV shifts.

Sometimes, it helps the patient just to know somebody is there who can take control of a situation. Other times it is not very nice to be with a really poorly patient and you've been waiting a long time for a real Ambulance (my record is 1 hour 20 minutes but I routinely wait 40-50 minutes). There's only so much that can be done before you need to get the patient into hospital. I've nearly been hung by family members wanting to know why there's no ambulance to move their loved ones.

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I think it can go either way. People are alleviated when the help they have called upon has arrived. Anxiety and tension may be relieved, even subtly, by our arrival. Afterall, I think all of us get those calls from people who just 'want to talk' when nothing is actually wrong.

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Hmmm... this one is hard to give a straight answer to. I believe if it is a standard granny run with no significant event occuring - Yes (e.g. I just feel a little dizzy and it burns to pee, hyperventilation, etc). i believer FR can make all the difference in these people.

However if it is a significant call like an MI , Anaphylaxis, CVA, There may be some brief anxiety reduction until the Pt figures out that holding hands does not break clots or reduce swelling.

Yes this mild relief is a positive thing....temporarily.

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I don't see how having a non-transporting unit arrive first is always a bad thing, or even most of time. Unless transport capable rigs have been sacrificed to get the non-transporting units on the road in which case it's completely and utterly f*cked up and wrong.

Even if it really is a placebo effect, that can help some patients...not all, but enough. Assuming that they are able to start the same level of care as the personnel on the ambulance it's still a good thing for those calls when an immediate intervention is needed, or when something we do will really and truly make a difference. Add in that for calls that don't need transport the initial unit should be able to handle it (in a perfect world anyway) and free up the ambulance for the next call and it's still good.

But. If the only reason it's being done is to bring response times down...that's a load of crap. Get more ambulances on the road and response times will drop. It's that simple. If the non-transport unit really can't do anything then it's pointless for them to be on every call, unless more manpower is needed. Unfortunately this seems to be the case more often than not.

Shite. Like a lot in US EMS it's something that could work for everyone's benefit if utilized correctly, but currently isn't in most places so it tends to be more for show than anything.

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I say yes,

Let's say someone is lying on the side of the road bleeding, people standing around not knowing what to do, the patient lying on the ground wondering if they will be ok.

The arrival of a professional in uniform, someone to control the situation will help put most people at ease, even if only a little.

It doesn't matter what qualification, as aussiephil said, anyone can do your basic ABC, apply pressure (in the above example) until a crew arrives.

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