Journal club: A pilot gap analysis survey of US emergency medical services practitioners to determine training and education needs pertaining to highly infectious disease preparedness and response

ABSTRACTObjectivesThere has been limited evaluation of handover from emergency medical services (EMS) to the trauma team. We sought to characterize these handover practices to identify areas of improvement and determine if handover standardization might be beneficial for trauma team performance.MethodsData were prospectively collected over a nine-week period by a trained observer at a Canadian level one trauma centre. A randomized scheduled was used to capture a representative breadth of handovers. Data collected included outcome measures such as duration of handover, structure of the handover, and information shared, process measures such as questions and interruptions from the trauma team, and perceptions of the handover from nurses, trauma team leaders and EMS according to a bidirectional Likert scale.Results79 formal verbal handovers were observed. Information was often missing regarding airway (present 22%), breathing (54%), medications (59%), and allergies (54%). Handover structure lacked consistency beyond the order of identification and mechanism of injury. Of all questions asked, 35% were questioning previously given information. The majority of handovers (61%) involved parallel conversations between team members while EMS was speaking. There was a statistically significant disparity between the self-evaluation of EMS handovers and the perceived quality determined by nurses and trauma team leaders.ConclusionsWe have identified the need to standardize handover due to poor information content, a lack of structure and active listening, information repetition, and discordant expectations between team members. These data will guide the development of a co-constructed framework integrating the perspectives of all team members.

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A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management

Journal of Occupational and Environmental Hygiene ◽

10.1080/15459624.2017.1319570 ◽

2017 ◽

Vol 14 (9) ◽

pp. 674-680 ◽

Cited By ~ 6

Author(s):

Aurora B. Le ◽

Lesley Witter ◽

Jocelyn J. Herstein ◽

Katelyn C. Jelden ◽

Elizabeth L. Beam ◽

...

Keyword(s):

Infectious Disease ◽

United States ◽

Gap Analysis ◽

The United States ◽

Training And Education ◽

Education Needs ◽

Death Care

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Review of Emergency Medical Services Vulnerability to High Consequence Infectious Disease in the United States

Frontiers in Public Health ◽

10.3389/fpubh.2021.748373 ◽

2021 ◽

Vol 9 ◽

Author(s):

Thomas W. Richey ◽

Raymond L. Fowler ◽

Ray E. Swienton ◽

James Patrick O'Neal ◽

Curtis A. Harris

Keyword(s):

Infectious Disease ◽

Emergency Medical Services ◽

Well Being ◽

The United States ◽

Medical Services ◽

Patient Transport ◽

Emergency Medical ◽

Wide Range ◽

The Us ◽

Training Standards

Purpose: Emergency medical services (EMS) responders are a group of medically skilled professionals who perform a wide range of essential medical services within a community including emergency response, patient transport, and mobile integrated healthcare. The proper functioning of the EMS system is paramount to the well-being of the medical system and public health. The intent of this paper is to review current EMS standards and practice to determine the danger a high consequence infectious disease (HCID) may pose to these healthcare workers and the community.Areas Addressed: Through the review of EMS practice several areas were identified as vulnerabilities to the EMS network. These vulnerabilities consisted of the lack of standardized licensing practice, inconsistent medical direction, and the inability to properly implement the use of personal protective equipment (PPE). The compounding of these vulnerabilities allows for HCIDs to pose a serious threat to EMS personnel with the possibility of devastating and crippling the EMS infrastructure within the US.Discussion: The vulnerabilities identified must be addressed both to protect EMS providers and to enhance the resilience of the US healthcare system. Ways to address the identified vulnerabilities should focus on improving the EMS curriculum and increasing minimum levels of education for first responders. Targeting minimum education and training standards could be the most effect method of reducing the dangers of HCIDs to EMS systems.

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Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments

Prehospital and Disaster Medicine ◽

10.1017/s1049023x16000959 ◽

2016 ◽

Vol 31 (6) ◽

pp. 675-679 ◽

Cited By ~ 5

Author(s):

Olindi Wijesekera ◽

Amanda Reed ◽

Parker S. Chastain ◽

Shauna Biggs ◽

Elizabeth G. Clark ◽

...

Keyword(s):

Infectious Disease ◽

Emergency Medical Services ◽

Emergency Departments ◽

Chart Review ◽

Retrospective Chart Review ◽

Medical Services ◽

Publication Type ◽

Patient Demographics ◽

Emergency Medical ◽

Chief Complaints

AbstractIntroductionWithout a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.MethodsA retrospective chart review was performed on patients transported by EMS over a three-month period in 2014 to four private EDs in India. A total of 17,541 patient records were sampled from the four sites over the study period. Of these records, 1,723 arrived by EMS and so were included for further review.ResultsA range of 1.4%-19.4% of ED patients utilized EMS to get to the ED. The majority of EMS patients were male (59%-64%) and adult or geriatric (93%-99%). The most common chief complaints and ED diagnoses were neurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease.ConclusionsNeurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease are the most common problems found in patients transported by EMS in India. Adult and geriatric male patients are the most common EMS utilizers. Emergency Medical Services curricula should emphasize these knowledge areas and skills.WijesekeraO, ReedA, ChastainPS, BiggsS, ClarkEG, KoleT, ChakrapaniAT, AshishN, RajhansP, BreaudAH, JacquetGA. Epidemiology of Emergency Medical Services (EMS) utilization in four Indian emergency departments. Prehosp Disaster Med. 2016;31(6):675–679.

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