Description of procedures performed on patients by emergency medical services during mass casualty incidents in the United States

AbstractBackgroundEmergency Medical Services (EMS) preparedness and availability of essential medications are important to reduce morbidity and mortality from mass-casualty incidents (MCIs).ObjectivesThis study describes prehospital medication administration during MCIs by different EMS service levels.MethodsThe US National EMS Public-Release Research Dataset maintained by the National Emergency Medical Services Information System (NEMSIS) was used to carry out the study. Emergency Medical Services activations coded as MCI at dispatch, or by EMS personnel, were included. The Center for Medicare and Medicaid Services (CMS) service level was used for the level of service provided. A descriptive analysis of medication administration by EMS service level was carried out.ResultsAmong the 19,831,189 EMS activations, 53,334 activations had an MCI code, of which 26,110 activations were included. There were 8,179 (31.3%) Advanced Life Support (ALS), 5,811 (22.3%) Basic Life Support (BLS), 399 (1.5%) Air Medical Transport (AMT; fixed or rotary), and 38 (0.2%) Specialty Care Transport (SCT) activations. More than 80 different medications from 18 groups were reported. Seven thousand twenty-one activations (26.9%) had at least one medication administered. Oxygen was most common (16.3%), followed by crystalloids (6.9%), unknown (5.2%), analgesics (3.2%) mainly narcotics, antiemetics (1.5%), cardiac/vasopressors/inotropes (0.9%), bronchodilators (0.9%), sedatives (0.8%), and vasodilators/antihypertensives (0.7%). Overall, medication administration rates and frequencies of medications groups significantly varied between EMS service levels (P<.01) except for “Analgesia (other)” (P=.40) and “Pain medications (nonsteroidal anti-inflammatory drug; NSAID)” (P=.07).ConclusionMedications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.El SayedM, TamimH, MannNC. Description of medication administration by Emergency Medical Services during mass-casualty incidents in the United States. Prehosp Disaster Med. 2016;31(2):141–149.

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(A231) Deficiencies in the Preparedness of Emergency Medical Services Providers for Terrorist Incidents Involving Children

Prehospital and Disaster Medicine ◽

10.1017/s1049023x11002172 ◽

2011 ◽

Vol 26 (S1) ◽

pp. s63-s63

Author(s):

M. Reilly

Keyword(s):

Public Health ◽

United States ◽

Emergency Medical Services ◽

A Priori ◽

The United States ◽

Medical Services ◽

Special Populations ◽

Provider Education ◽

Emergency Medical ◽

Nationally Representative

IntroductionRecent studies have discussed major deficiencies in the preparedness of emergency medical services (EMS) providers to effectively respond to disasters, terrorism and other public health emergencies. Lack of funding, lack of national uniformity of systems and oversight, and lack of necessary education and training have all been cited as reasons for the inadequate emergency medical preparedness in the United States.MethodsA nationally representative sample of over 285,000 emergency medical technicians (EMTs) and Paramedics in the United States was surveyed to assess whether they had received training in pediatric considerations for blast and radiological incidents, as part of their initial provider education or in continuing medical education (CME) within the previous 24 months. Providers were also surveyed on their level of comfort in responding to and potentially treating pediatric victims of these events. Independent variables were entered into a multivariate model and those identified as statistically significant predictors of comfort were further analyzed.ResultsVery few variables in our model caused a statistically significant increase in comfort with events involving children in this sample. Pediatric considerations for blast or radiological events represented the lowest levels of comfort in all respondents. Greater than 70% of respondents reported no training as part of their initial provider education in considerations for pediatrics following blast events. Over 80% of respondents reported no training in considerations for pediatrics following events associated with radiation or radioactivity. 88% of respondents stated they were not comfortable with responding to or treating pediatric victims of a radiological incident.ConclusionsOut study validates our a priori hypothesis and several previous studies that suggest deficiencies in preparedness as they relate to special populations - specifically pediatrics. Increased education for EMS providers on the considerations of special populations during disasters and acts of terrorism, especially pediatrics, is essential in order to reduce pediatric-related morbidity and mortality following a disaster, act of terrorism or public health emergency.

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National characteristics of non-transported children by Emergency Medical Services (EMS) in the United States

Prehospital Emergency Care ◽

10.1080/10903127.2021.1985666 ◽

2021 ◽

pp. 1-15

Author(s):

Caleb Ward ◽

Anqing Zhang ◽

Kathleen Brown ◽

Joelle Simpson ◽

James Chamberlain

Keyword(s):

United States ◽

Emergency Medical Services ◽

The United States ◽

Medical Services ◽

Emergency Medical ◽

National Characteristics

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Abstract 203: Characteristics of Emergency Medical Service Responses for Adults With Cardiovascular Disease-related Chief Complaints in The United States, 2016

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.203 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Isaac A Nwaise ◽

Erika C Odom

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Emergency Medical Services ◽

Statistical Tests ◽

The United States ◽

Medical Services ◽

National Database ◽

Patient Disposition ◽

Emergency Medical ◽

Chief Complaints

Background: Gaps exist in understanding the commonality of cardiovascular disease (CVD)-related responses by emergency medical services responders in the United States (US) community setting. Objective: We examined characteristics of CVD-related responses among US adults with 9-1-1 emergency medical services (EMS) responses in a national database. Methods: The 2016 National Emergency Medical Services Information System (NEMSIS) database (Version 2.2.1) from 49 states was used. CVD-related chief complaints were defined by data element E09_12 in the NEMSIS code book. Exclusions were EMS cancellations, persons not found, those with unknown sex, and patients aged <18 years. Rates (per 1,000 EMS responses) were calculated for total population and by patient demographics. Chi-square statistical tests were used to assess associations. Percentages of CVD-related chief complaints were calculated for EMS responses (incident patient disposition, type of destination, and reasons for destination), and clinical characteristics (provider’s primary impression, provider’s secondary impression, primary symptom, and EMS condition code). Results: We identified over 19.8 million EMS responses among adults aged ≥18 years old in 2016, including 1,336,684 (67.4 per 1,000 EMS responses) with CVD-related chief complaints. Rates of CVD-related chief complaints per 1,000 EMS responses for females (68.5), patients aged 65-74 years old (87.7), Hawaiian Pacific Islanders (83.6), whites (73.4), and those living in the South census region (72.8) were significantly higher than their respective counterparts. Among EMS responses, most CVD-related chief complaints were treated and transported by EMS (83.1%), and of those transported by EMS, 83.5% were transported to a hospital. Reasons for hospital destinations among adults with CVD-related chief complaints were patient’s preferred hospital (34%) and closest facility (32.9%). Most CVD-related chief complaints were chest pain or discomfort according to provider’s primary impression (48%) and provider’s secondary impressions (6.1%). Finally, pain (46.2%) was the most frequently reported condition as primary symptom among EMS patient with CVD-related chief complaints. Conclusion: Approximately 1-in-15 EMS (9-1-1) responses among adults involved a CVD-related chief complaint. Future research could focus on trends for CVD-related EMS responses overtime. Keyword: 9-1-1 emergency system, prehospital cardiovascular disease, CVD-related events.

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Optical Head-Mounted Displays in Mass Casualty Incidents

International Journal of Information Systems for Crisis Response and Management ◽

10.4018/ijiscram.2015070101 ◽

2015 ◽

Vol 7 (3) ◽

pp. 1-15 ◽

Cited By ~ 6

Author(s):

Henrik Berndt ◽

Tilo Mentler ◽

Michael Herczeg

Keyword(s):

Emergency Medical Services ◽

Interaction Design ◽

Crisis Response ◽

Mass Casualty ◽

Mass Casualty Incidents ◽

Medical Services ◽

Optical Head ◽

Emergency Medical ◽

Head Mounted Displays ◽

Free Interaction

Optical head-mounted displays (OHMDs) could support members of emergency medical services in responding to and managing mass casualty incidents. In this contribution, the authors describe the human-centered design of two applications for supporting the triage process as well as the identification of hazardous materials. They were evaluated with members of emergency medical services and civil protection units. In this regard, challenges and approaches to human-computer interaction with OHMDs in crisis response and management are discussed. The conclusion is drawn that often mentioned advantages of OHMDs like hands-free interaction alone will not lead to usable solutions for safety-critical domains. Interaction design needs to be carefully considered right down to the last detail.

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