Even After Death, Heart Attack Treatment May Not End

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She said that paramedics often feel pressured by these expectations to transport the patient to a hospital. What people don't realize, Sasson said, is that the care paramedics provide in the field is exactly the same treatment that the patient would receive in the hospital.

Another problem, Sasson said, is that health insurers -- including Medicare -- pay less for paramedic care than for care in a hospital. "There is a large financial disincentive for paramedics to stay on scene," she said.

Also, she said, some states "mandate that every cardiac arrest patient get transported to the hospital." And some require that even people with do-not-resuscitate orders must be treated if the person does not have the proper state form in his or her possession, she said.

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Taking people to a hospital needlessly for treatment also creates what Sasson described as an opportunity cost.

"When you bring in a patient that is essentially dead, all of your resources go to that patient, which leaves the rest of the emergency department unmanned," she said. "When you are trying to resuscitate someone who should have never been transported to the hospital in the first place, you are shifting away resources from people who actually have conditions that are treatable."

The findings explained by Sasson stemmed from three small focus groups, including emergency physicians and emergency medical services (EMS) directors, conducted during the 2008 National Association of Emergency Medical Services Physicians meeting in Jacksonville, Fla.

Sasson and her fellow researchers concluded that, to help solve the problems pointed out by the focus group members, state laws need to be brought into line with American Heart Association guidelines and payment for paramedic care needs to be based on the care that's given, not on where it's given. Also, she said, the public needs to be made more aware of the realities of surviving a heart attack.

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