The Usefulness of Urban Paramedics

To the Editor.— Smith and Bodai¹broached an important issue in attempting to define urban paramedics' scope of practice; unfortunately, their presentation was curiously one sided. I could find no information in their reference 9 about increased costs of paramedic programs,²as claimed, nor could I find anything in reference 7 to support their statement that surgical patients may be harmed by care at the scene of the injury.³Although it is a small point, I believe that the first report of successful prehospital defibrillation was made by Pantridge and Geddes⁴in 1967, not Adgey in 1969. The "Hypovolemia" section of the review stated that a number of patients died "because of delays in transport caused by paramedic interventions," and they refer to their retrospective review of 15 patients published in abstract form. Their full report is now available, and I find it impossible, when reading