scholarly journals Emergency Medical Services Clinicians’ Pediatric Destination Decision-Making: A Qualitative Study

Cureus ◽  
2021 ◽  
Author(s):  
Kyle A Fratta ◽  
Jennifer N Fishe ◽  
Ellen Schenk ◽  
Jennifer F Anders
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical

Naturalistic Decision-Making in Emergency Medical Services

2017 ◽  
pp. 41-52
Author(s):  
Michael A. Rosen ◽  
Ian Coffman ◽  
Aaron Dietz ◽  
P. Daniel Patterson ◽  
Julius Cuong-Pham
Keyword(s):  
Decision Making ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Naturalistic Decision Making ◽  
Emergency Medical

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 Variation in the delivery of telephone advice by emergency medical services: a qualitative study in three services

2019 ◽  
Vol 28 (7) ◽  
pp. 556-563
Author(s):  
Rachel O'Hara ◽  
Lindsey Bishop-Edwards ◽  
Emma Knowles ◽  
Alicia O'Cathain
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Participant Observation ◽  
Geographical Location ◽  
Medical Services ◽  
Alternative Response ◽  
Response Options ◽  
Emergency Medical ◽  
Telephone Advice ◽  
On The Road

BackgroundAn emergency ambulance is not always the appropriate response for emergency medical service patients. Telephone advice aims to resolve low acuity calls over the phone, without sending an ambulance. In England, variation in rates of telephone advice and patient recontact between services raises concerns about inequities in care. To understand this variation, this study aimed to explore operational factors influencing the provision of telephone advice.MethodsThis is a multimethod qualitative study in three emergency medical services in England with different rates of telephone advice and recontact. Non-participant observation (120 hours) involved 20 call handlers and 27 clinicians (eg, paramedics). Interviews were conducted with call handlers, clinicians and clinician managers (n=20).ResultsServices varied in their views of the role of telephone advice, selection of their workforce, tasks clinicians were expected and permitted to do, and access to non-ambulance responses. Telephone advice was viewed either as an acceptable approach to managing demand or a way of managing risk. The workforce could be selected for their expertise or their inability to work ‘on-the-road’. Some services permitted proactive identification of calls for a lower priority response and provided access to a wider range of response options. The findings aligned with telephone advice rates for each service, particularly explaining why one service had lower rates.ConclusionSome of the variation observed can be explained by operational differences between services and some of it by access to alternative response options in the wider urgent and emergency care system. The findings indicate scope for greater consistency in the delivery of telephone advice to ensure the widest range of options to meet the needs of different populations, regardless of geographical location.

scholarly journals Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making

CJEM ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 220-229
Author(s):  
Jan L. Jensen ◽  
Andrew H. Travers
Keyword(s):  
Decision Making ◽  
Emergency Medical Services ◽  
Evidence Based Practice ◽  
Systems Of Care ◽  
National Level ◽  
Policy Decision ◽  
Medical Services ◽  
Evidence Based ◽  
Emergency Medical ◽  
Patient Health

AbstractNationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

Emergency Medical Services Provider Perspectives on Pediatric Calls: A Qualitative Study

2019 ◽  
Vol 23 (4) ◽  
pp. 501-509 ◽  
Author(s):  
Jessica N. Jeruzal ◽  
Lori L. Boland ◽  
Monica S. Frazer ◽  
Jonathan W. Kamrud ◽  
Russell N. Myers ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Provider Perspectives ◽  
Emergency Medical

scholarly journals MANAGING DEATH IN THE FIELD: HOW EMERGENCY MEDICAL SERVICES TEAMS PROVIDE END-OF-LIFE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S499
Author(s):  
Deborah P Waldrop ◽  
Jacqueline M McGinley ◽  
Brian M Clemency
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Emergency Medical Services ◽  
End Of Life ◽  
End Of Life Care ◽  
Medical Services ◽  
Life Care ◽  
Serious Illness ◽  
Emergency Medical ◽  
Seriously Ill

Abstract Emergency medical services (EMS) providers respond more frequently to calls for older adults with serious illness than for people in other age groups. Recent legislation that makes it possible to document healthcare decisions has facilitated an era of choice in end-of-life care. EMS teams make time-sensitive decisions about care, resuscitation and hospital transport that influence how and where a seriously ill older adult will die and how his/her family will experience the death. Yet, EMS providers’ perspectives on urgent decision-making and how they work with families are unknown. The purpose of this study was to explore the decision-making process that occurs how EMS teams respond when someone is dying from a serious illness (vs. an injury). In-depth in-person interviews were conducted with 50 EMS providers (24 emergency medical technicians [EMTs] and 26 Paramedics) from four ambulance services. Participants’ ages ranged from 21-57 (M=37.9) and 70% were male. Qualitative data was coded using Atlas.ti software. Three themes illuminated participants’ experiences with end-of-life calls: (1) How legally binding documents (e.g. Do Not Resuscitate [DNR] orders, Medical Orders for Life Sustaining Treatment [MOLST]) inform care; (2) Decision-making about foregoing or halting resuscitation (e.g. no hospitalization, death at home); and (3) Family care, support and education. The results suggest that EMS providers have critically important roles in upholding the wishes of seriously ill older adults and helping caregiving families through the end-of-life transition. Implications: Discussions about the meaning of legally binding documents (e.g. DNR, MOLST) and EMS calls are important in advance care planning.

scholarly journals Barriers to utilization of pre-hospital emergency medical services among residents in Libreville, Gabon: A qualitative study

2013 ◽  
Vol 3 (4) ◽  
pp. 172-177 ◽  
Author(s):  
Nichole Bosson ◽  
Michael A. Redlener ◽  
George L. Foltin ◽  
Maria C. Raven ◽  
Mark P Foran ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Hospital Emergency ◽  
Emergency Medical
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