Knowledge Translation in the Emergency Medical Services: A Research Agenda for Advancing Prehospital Care

2007 ◽  
Vol 14 (11) ◽  
pp. 1052-1057 ◽  
Author(s):  
D. C. Cone
Keyword(s):  
Knowledge Translation ◽  
Emergency Medical Services ◽  
Research Agenda ◽  
Prehospital Care ◽  
Medical Services ◽  
Emergency Medical

Prehospital Care for Victims of Submersion

PEDIATRICS ◽  
1990 ◽  
Vol 86 (4) ◽  
pp. 625-626
Author(s):  
MARTHA BUSHORE
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Growth And Development ◽  
Prehospital Care ◽  
Rapid Response ◽  
Urban Setting ◽  
Medical Services ◽  
Emergency Medical ◽  
Study Results

In this issue of Pediatrics is a study1 that represents a milestone in the growth and development of Emergency Medical Services for Children systems. Linda Quan and co-workers provide us with a study of victims of submersion who were less than 20 years of age and who received care during a 10-years interval in an Emergency Medical Services unit and required hospitalization or died. Because the majority of these submersions occurred in the urban setting of King Country with the rapid response of Emergency Medical Services units and reliable recording of cardiopulmonary resuscitation (CPR) data, the study results are impressively complete.

Pediatric Prehospital Care in Urban and Rural Areas

PEDIATRICS ◽  
1991 ◽  
Vol 88 (4) ◽  
pp. 681-690 ◽  
Author(s):  
James S. Seidel ◽  
Deborah Parkman Henderson ◽  
Patrick Ward ◽  
Barbara Wray Wayland ◽  
Beverly Ness
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Urban Areas ◽  
Pediatric Patients ◽  
Life Support ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Medical Services ◽  
Care Providers ◽  
Emergency Medical

There are limited data concerning pediatric prehospital care, although pediatric prehospital calls constitute 10% of emergency medical services activity. Data from 10 493 prehospital care reports in 11 counties of California (four emergency medical services systems in rural and urban areas) were collected and analyzed. Comparison of urban and rural data found few significant differences in parameters analyzed. Use of the emergency medical services system by pediatric patients increased with age, but 12.5% of all calls were for children younger than 2 years. Calls for medical problems were most common for patients younger than 5 years of age; trauma was a more common complaint in rural areas (64%, P = .0001). Frequency of vital sign assessment differed by region, as did hospital contact (P < .0001). Complete assessment of young pediatric patients, with a full set of vital signs and neurologic assessment, was rarely performed. Advanced life support providers were often on the scene, but advanced life support treatments and procedures were infrequently used. This study suggests the need for additional data on which to base emergency medical services system design and some directions for education of prehospital care providers.

Optimizing Routine and Disaster Prehospital Care Through Improved Emergency Medical Services Oversight

2020 ◽  
pp. 1-13
Author(s):  
Mahshid Abir ◽  
Jane Forman ◽  
Rekar K. Taymour ◽  
Christina Brent ◽  
Brahmajee K. Nallamothu ◽  
...  
Keyword(s):  
Rural Communities ◽  
Emergency Medical Services ◽  
Disaster Response ◽  
Prehospital Care ◽  
Rapid Assessment ◽  
Medical Services ◽  
Primary Data ◽  
Current Evidence ◽  
Emergency Medical ◽  
Facilitators And Barriers

ABSTRACT Objective: To identify modifiers of emergency medical services (EMS) oversight quality, including facilitators and barriers, and inform best practices and policy related to EMS oversight and system performance. Methods: We used a qualitative design, including 4 focus groups and 10 in-depth, 1-on-1 interviews. Primary data were collected from EMS stakeholders in Michigan from June to July 2016. Qualitative data were analyzed using the rapid assessment technique. Results: Emergent themes included organizational structure, oversight and stakeholder leadership, interorganizational communication and relationships, competition or collaboration among MCA stakeholders, quality improvement practices, resources, and needs specific to rural communities. Conclusions: EMS is a critical component of disaster response. This study revealed salient themes and modifiers, including facilitators and barriers, of EMS oversight quality. These findings were evaluated in the context of current evidence and informed state policy to improve the quality of EMS oversight and prehospital care for both routine and disaster settings. Some were particular to geographic regions and communities, whereas others were generalizable.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study

2016 ◽  
Vol 32 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Seth A. Brown ◽  
Theresa C. Hayden ◽  
Kimberly A. Randell ◽  
Lara Rappaport ◽  
Michelle D. Stevenson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Focus Groups ◽  
Emergency Medical Services ◽  
Prehospital Care ◽  
Educational Interventions ◽  
Medical Services ◽  
Theory Approach ◽  
Publication Type ◽  
Pediatric Education ◽  
Emergency Medical

AbstractObjectivesPrevious studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements.MethodsPurposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data.ResultsForty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements.ConclusionFocus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care.BrownSA, HaydenTC, RandellKA, RappaportL, StevensonMD, KimIK. Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20–26.

scholarly journals Knowledge translation in emergency medical services: A qualitative survey of barriers to guideline implementation

Resuscitation ◽  
2010 ◽  
Vol 81 (7) ◽  
pp. 836-840 ◽  
Author(s):  
Blair L. Bigham ◽  
Tom P. Aufderheide ◽  
Daniel P. Davis ◽  
Judy Powell ◽  
Stuart Donn ◽  
...  
Keyword(s):  
Knowledge Translation ◽  
Emergency Medical Services ◽  
Guideline Implementation ◽  
Medical Services ◽  
Qualitative Survey ◽  
Emergency Medical

Policy, Practice, and Research Agenda for Emergency Medical Services Oversight: A Systematic Review and Environmental Scan

2018 ◽  
Vol 33 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Rekar K. Taymour ◽  
Mahshid Abir ◽  
Margaret Chamberlin ◽  
Robert B. Dunne ◽  
Mark Lowell ◽  
...  
Keyword(s):  
New York ◽  
Emergency Medical Services ◽  
Research Agenda ◽  
Grey Literature ◽  
Quality Measurement ◽  
Medical Services ◽  
Washington Dc ◽  
Environmental Scan ◽  
Policy Practice ◽  
Emergency Medical

AbstractIntroductionIn a 2015 report, the Institute of Medicine (IOM; Washington, DC USA), now the National Academy of Medicine (NAM; Washington, DC USA), stated that the field of Emergency Medical Services (EMS) exhibits signs of fragmentation; an absence of system-wide coordination and planning; and a lack of federal, state, and local accountability. The NAM recommended clarifying what roles the federal government, state governments, and local communities play in the oversight and evaluation of EMS system performance, and how they may better work together to improve care.ObjectiveThis systematic literature review and environmental scan addresses NAM’s recommendations by answering two research questions: (1) what aspects of EMS systems are most measured in the peer-reviewed and grey literatures, and (2) what do these measures and studies suggest for high-quality EMS oversight?MethodsTo answer these questions, a systematic literature review was conducted in the PubMed (National Center for Biotechnology Information, National Institutes of Health; Bethesda, Maryland USA), Web of Science (Thomson Reuters; New York, New York USA), SCOPUS (Elsevier; Amsterdam, Netherlands), and EMBASE (Elsevier; Amsterdam, Netherlands) databases for peer-reviewed literature and for grey literature; targeted web searches of 10 EMS-related government agencies and professional organizations were performed. Inclusion criteria required peer-reviewed literature to be published between 1966-2016 and grey literature to be published between 1996-2016. A total of 1,476 peer-reviewed titles were reviewed, 76 were retrieved for full-text review, and 58 were retained and coded in the qualitative software Dedoose (Manhattan Beach, California USA) using a codebook of themes. Categorizations of measure type and level of application were assigned to the extracted data. Targeted websites were systematically reviewed and 115 relevant grey literature documents were retrieved.ResultsA total of 58 peer-reviewed articles met inclusion criteria; 46 included process, 36 outcomes, and 18 structural measures. Most studies applied quality measures at the personnel level (40), followed by the agency (28) and system of care (28), and few at the oversight level (5). Numerous grey literature articles provided principles for high-quality EMS oversight.Conclusions:Limited quality measurement at the oversight level is an important gap in the peer-reviewed literature. The grey literature is ahead in this realm and can guide the policy and research agenda for EMS oversight quality measurement.TaymourRK, AbirM, ChamberlinM, DunneRB, LowellM, WahlK, ScottJ. Policy, practice, and research agenda for Emergency Medical Services oversight: a systematic review and environmental scan. Prehosp Disaster Med. 2018;33(1):89–97.

scholarly journals Frequency and severity of prehospital obstetric events encountered by emergency medical services in the United States

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca E. Cash ◽  
Robert A. Swor ◽  
Margaret Samuels-Kalow ◽  
David Eisenbrey ◽  
Anjali J. Kaimal ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Prehospital Care ◽  
The United States ◽  
Medical Services ◽  
Patient Acuity ◽  
Cohen’S Kappa ◽  
Specific Patient ◽  
Cohen's Kappa ◽  
Emergency Medical ◽  
High Acuity

Abstract Background Prehospital obstetric events encountered by emergency medical services (EMS) can be high-risk patient presentations for which suboptimal care can cause substantial morbidity and mortality. The frequency of prehospital obstetric events is unclear because existing descriptions have reported obstetric and gynecological conditions together, without delineating specific patient presentations. Our objective was to identify the types, frequency, and acuity of prehospital obstetric events treated by EMS personnel in the US. Methods We conducted a cross-sectional analysis of EMS patient care records in the 2018 National EMS Information System dataset (n=22,532,890). We focused on EMS activations (i.e., calls for service) for an emergency scene response for patients aged 12-50 years with evidence of an obstetric event. Type of obstetric event was determined by examining patient symptoms, the treating EMS provider’s impression (i.e., field diagnosis), and procedures performed. High patient acuity was ascertained by EMS documentation of patient status and application of the modified early obstetric warning system (MEOWS) criteria, with concordance assessed using Cohen’s kappa. Descriptive statistics were calculated to describe the primary symptoms, impressions, and frequency of each type of obstetric event among these activations. Results A total of 107,771 (0.6%) of EMS emergency activations were identified as involving an obstetric event. The most common presentation was early or threatened labor (15%). Abdominal complaints, including pain and other digestive/abdomen signs and symptoms, was the most common primary symptom (29%) and primary impression (18%). We identified 3,489 (3%) out-of-hospital deliveries, of which 1,504 were preterm. Overall, EMS providers documented 34% of patients as being high acuity, similar to the MEOWS criteria (35%); however, there were high rates of missing data for EMS documented acuity (19%), poor concordance between the two measures (Cohen’s kappa=0.12), and acuity differences for specific conditions (e.g., high acuity of non-cephalic presentations, 77% in EMS documentation versus 53% identified by MEOWS). Conclusion Prehospital obstetric events were infrequently encountered by EMS personnel, and about one-third were high acuity. Additional work to understand the epidemiology and clinical care of these patients by EMS would help to optimize prehospital care and outcomes.

scholarly journals Collaboration for preliminary design of a mobile health solution for ambulance dispatch in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Ashley Rosenberg ◽  
◽  
Rob Rickard ◽  
Fraterne Zephyrin Uwinshuti ◽  
Gabin Mbanjumucyo ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Capital City ◽  
Medical Services ◽  
Middle Income ◽  
Golden Hour ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Prehospital Emergency

The first 60 minutes after a trauma are described as “the golden hour.” For each minute of prehospital time, the risk of dying increases by 5% (Sampalis et al., 1999). Since 90% of the global burden of injuries occur in low- and middle-income countries and lead to 5.8 million deaths annually, addressing rapid access to emergency services is critical in these settings (Nielsen et al., 2012). In most low- and middle-income countries (LMICs), there are no formal trauma systems, and many lack organized prehospital care (Nielsen et al., 2012). Emergency medical dispatch and communication systems are a foundational component of emergency medical services (World Health Organization, 2005). Yet there are no established recommendations of creating these systems inLMICs.Rwanda, a country of over 12 million people, is a rapidly developing leader in East Africa. The Ministry of Health of Rwanda established the Service d’Aide Medicale Urgente (SAMU) in 2007, recognizing the need for public emergency medical services. SAMU’s national dispatch center receives roughly 3,000 calls per month through a national 912 hotline. It organizes regional transportation with 260 total ambulances located at hospitals throughout the country and provides prehospital emergency services in the capital city of Kigali with a fleet of 12 ambulances. In the city, each ambulance has a driver, nurse and anesthetist dispatched for every call. Emergency department nursing and anesthetist staff are dispatched from hospitals around the country to respond to regional emergencies. No formal prehospital cadre of the workforce exists although the SAMU staffhave extensive field experience in prehospital care. SAMU has several challenges to rapid prehospital emergency care including lack of addresses beyond the capital city, unclear location data in densely populated areas, complex communication processes with little information about health facility capacity, and no established electronic dispatch system. The average response time for SAMU ambulances was 59 minutes in 2018, but 39% of calls were not completed within the golden hour.

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