The AHA establishes BLS and ALS treatment guidelines based on the strongest evidence available. Because their guidelines need to be broadly applicable the guideline writing committees take a very conservative approach to changes in response to available literature. BUT, from where does the evidence and literature emerge? It comes from systems that do not necessarily follow the guidelines. That is correct, systems violate the AHA guidelines. This is necessary for the evolution of resuscitation. This talk will describe the approach to the establishment of a resuscitation program custom tailored to fit the needs of a large urban fire based EMS system. We will discuss the QA/QI requirements, regulatory hurdles, and education need to establish best practices for the local environment.
Learning Objectives:

Discuss the implications of diverting from AHA Resuscitation Guidelines
Discuss issues such as National Registry and state regulator considerations
Discuss the inclusion of research into the clinical practice of EMS