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February 7, 1986

The Usefulness of Urban Paramedics

JAMA. 1986;255(5):611. doi:10.1001/jama.1986.03370050047011

To the Editor.—  In their article, "The Urban Paramedic's Scope of Practice," Drs Smith and Bodai1 state that paramedics should treat most prehospital emergencies by a "load-and-go" policy. Although some of their conclusions may be valid, they have presented data that are misleading, and therefore their conclusions require a second look.The most misleading piece of information pertains to the time it takes a paramedic to start an intravenous (IV) line in the field. Citing an article by McSwain et al,2 they state that it has been demonstrated that the average time for starting an IV line in the field is 11 minutes. McSwain and co-workers' article, which reviewed 100 cases of resuscitation from cardiopulmonary arrest by paramedics, noted that patients in whom IV line placement was attempted spent additional time at the scene averaging about 12 minutes. The investigators in that study did not measure the time