"Ambulances are dangerous places"

From Slate magazine, as excerpted and commented upon by Medlaw.com:

By Zachary Meisel MD from SLATE Magaine
Posted Wednesday, November 9, 2005

Not long ago in Western Pennsylvania, an ambulance was dispatched to help an elderly woman whose heart was beating irregularly. Although the patient was awake and her blood pressure was normal, the paramedics on the scene detected a worrisome cardiac rhythm on their monitor: The heart was beating too fast, and each beat appeared widened on the screen. The patient's condition was consistent with a serious and sometimes fatal heart rhythm called ventricular tachycardia. One of the paramedics called a local hospital, and a doctor there told him to administer intravenously 100 milligrams of a potent anti-arrhythmic drug, intravenous lidocaine hydrochloride. In the cramped ambulance, the medic grabbed a 2-gram syringe of lidocaine in concentrated form, which must be diluted in a bag of saline and dripped into the vein slowly. Thinking he had a different vial, the paramedic quickly injected the entire syringe into the patient. The woman went into cardiac arrest and died.

In 1999, the Institute of Medicine published its report To Err Is Human, which estimated that up to 98,000 patients may die each year because of the mistakes of doctors, nurses, and other hospital workers. But few published studies have tried to quantify or even characterize the injuries to patients that take place before they reach the hospital. How frequent and how serious are the mistakes that take place in ambulances—and are there simple changes that could help prevent them?