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In 1986, Vern L. Katz, Deborah J. Dotters, and William Droegemueller published “Perimortem Cesarean Delivery,” an article in which they developed the Four Minute Rule for perimortem cesarean sections. The Four Minute Rule states that if a pregnant woman’s heart stops beating, physicians should begin an operation to deliver the fetus within four minutes and aim to have the fetus delivered within five minutes of cardiac arrest. Although cardiac arrest during pregnancy is uncommon, it can happen when pregnant women experience trauma, blood clots, infection, or have preexisting heart conditions. In the article, the authors emphasize how the Four Minute Rule increased maternal and fetal survival rates and decreased cases of severe fetal brain damage. The article “Perimortem Cesarean Delivery” was the first article to present the Four Minute Rule, which has influenced international guidelines and become the standard for maternal resuscitation and fetal survival in emergency medicine, operating rooms, and many other aspects of medical practice.
This honors thesis project focuses upon the PEMS EMPRA program. The research question that the project seeks to answer is the following: what are the current recruiting, training, and quality control practices of the PEMS EMPRA program and how can these said practices be improved? The interest in this topic lies in providing an insightful, multi-faceted view of the day-to-day operations of a medical scribe program. The main goals of this project are to give a complete assessment of the present recruitment, training, and quality control practices of PEMS as well as provide insights and suggestions for improving the program as a whole.