Educating for the Future of Emergency Medical Services Systems

1986 ◽  
Vol 2 (1-4) ◽  
pp. 171-174
Author(s):  
D.L. Gordon ◽  
R.A. Cowley
Keyword(s):  
Emergency Medical Services ◽  
Systems Of Care ◽  
The United States ◽  
Academic Program ◽  
Medical Services ◽  
Baltimore County ◽  
Medical Systems ◽  
Emergency Medical ◽  
The Future ◽  
Emergency Systems

A bachelor's degree in EMS management was the initial course of studies in an academic program designed to prepare people to work in a variety of occupations in EMS.This paper includes a brief history of that program, its purposes, goals and curriculum and the first data on follow up of its graduates.In the United States of America, the Emergency Medical Systems (EMS) act of 1973 stimulated people from a variety of fields and backgrounds to work together to develop and manage emergency systems of care; it also raised the question of how to prepare people to meet the future needs of the system. At that time, and with few exceptions, there was little or no academic involvement directed to the concept of the system of EMS and there was a dearth of persons with predictable knowledge and skills in this area. The apparent need for preparing leadership personnel for EMS became the focus of thinking by the Maryland Institute of Emergency Medical Services Systems (MIEMSS) and the University of Maryland, Baltimore County (UMBC).

An Historical Examination of the Development of Emergency Medical Services Education in the US through Key Reports (1966-2014)

2015 ◽  
Vol 31 (1) ◽  
pp. 90-97 ◽  
Author(s):  
Ingrid A. Brooks ◽  
Michael R. Sayre ◽  
Caroline Spencer ◽  
Frank L. Archer
Keyword(s):  
Emergency Medical Services ◽  
The United States ◽  
Medical Services ◽  
Education Development ◽  
Emergency Medical ◽  
The Us ◽  
The Future ◽  
Ems Education ◽  
Google Search ◽  
Historical Examination

AbstractIntroductionThe Emergency Medical Services (EMS) approach to emergency prehospital care in the United States (US) has global influence. As the 50-year anniversary of modern US EMS approaches, there is value in examining US EMS education development over this period. This report describes US EMS education milestones and identifies themes that provide context to readers outside the US.MethodAs US EMS education is described mainly in publications of federal US EMS agencies and associations, a Google search and hand searching of documents identified publications in the public domain. MEDLINE and CINAHL Plus were searched for peer reviewed publications. Documents were reviewed using both a chronological and thematic approach.ResultsSeventy-eight documents and 685 articles were screened, the full texts of 175 were reviewed, and 41 were selected for full review. Four historical periods in US EMS education became apparent: EMS education development (1966-1980); EMS education consolidation and review (1981-1989); EMS education reflection and change (1990-1999); and EMS education for the future (2000-2014). Four major themes emerged: legislative authority, physician direction, quality, and development of the profession.ConclusionDocuments produced through broad interprofessional consultations, with support from federal and US EMS authorities, reflect the catalysts for US EMS education development. The current model of US EMS education provides a structure to enhance educational quality into the future. Implementation evaluation of this model would be a valuable addition to the US EMS literature. The themes emerging from this review assist the understanding of the characteristics of US EMS education.BrooksIA, SayreMR, SpencerC, ArcherFL. An historical examination of the development of Emergency Medical Services education in the US through key reports (1966-2014). Prehosp Disaster Med. 2016;31(1):90–97.

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

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.

Abstract P138: Improving Emergency Medical Services Documentation of Time Last Known Well

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Dot Bluma ◽  
Jessica Link Reeve ◽  
Susan M Godersky
Keyword(s):  
Emergency Medical Services ◽  
Symptom Onset ◽  
Systems Of Care ◽  
Onset Time ◽  
Reperfusion Therapy ◽  
Report Card ◽  
Medical Services ◽  
Emergency Department Physician ◽  
Measure Data ◽  
Emergency Medical

Background and Purpose: In a systems of care model, Emergency Medical Services (EMS) reporting a patient’s last known well (LKW) time to the receiving hospital is crucial for activation of the hospitals Acute Stroke Team. There is evidence that LKW is critical information for determining an acute ischemic stroke patient’s eligibility for advanced stroke therapy which includes intravenous Alteplase and/or mechanical endovascular reperfusion therapy. The 70 Wisconsin (WI) Coverdell Stroke Program (Coverdell) hospitals represent 80% of stroke admissions in WI. Coverdell developed a pre-arrival report card in Q3 2018 in which LKW was a tracked measure. Data entered into Get With The Guidelines®- Special Initiatives (SI) tab was collated to create the report card. After analysis of the data it was determined our performance improvement (PI) project would be to improve EMS’s documentation and reporting of time LKW. In Q3 2018, of those cases entered into the SI tab, EMS reporting a LKW time was 50%. Since LKW is not always obtainable, the project goal was set at 60%. Methods: We recognized implementation of this PI initiative would require a multi-prong approach. To assist EMS agencies in understanding the difference between LKW and symptom onset, we developed a document entitled, The Importance of an Accurate Last Known Well and Symptom Onset Time . A Coverdell team member attended WI’s EMS Physician Advisory Committee meetings where LKW data was discussed. In addition, an Emergency Department Physician hosted a webinar where the presentation highlighted the importance of documenting LKW. This webinar was recorded and sent to EMS agencies and hospitals. For loop closure and with the support of the WI’s EMS Director, LKW became a validated field for EMS in the WI Ambulance Run Data System. Findings: In Q2 2019 there was an improvement in documented LKW as evidenced by an increase to 59.2% The data has remained consistent even as more hospitals have begun to enter the data as demonstrated by the increasing N. Conclusion: The actions taken by the Coverdell program in educating EMS providers on the rationale and importance of LKW documentation was successful. However, additional efforts are required to reach and maintain the project goal of 60% with an additional stretch goal to 70%.

A Call to Action: The Institute of Medicine Report on Emergency Medical Services for Children

PEDIATRICS ◽  
1995 ◽  
Vol 96 (1) ◽  
pp. 173-174
Author(s):  
Jane F. Knapp
Keyword(s):  
Emergency Medical Services ◽  
Pediatric Emergency ◽  
Medical Services ◽  
Institute Of Medicine ◽  
Medical Systems ◽  
Call To Action ◽  
Emergency Medical ◽  
Grant Program ◽  
Public Responsibility ◽  
Emergency Medical Systems

Emergency Medical Services for Chi (EMS-C) must be recognized as a public responsibility; the "market" cannot be relied on to produce the kind of planning and cooperation required to make services available to all who need them.1 The Institute of Medicine (IOM) Report on Emergency Medical Services For Children. Each year millions of American chi become seriously ill or injured. If you have ever encountered a child who did not receive the medical care they needed or deserved under these circumstances you understand what EMS-C is all about. The familiar adage, "Children are not small adults," emphasizes that their care must be an integral part of a system not an afterthought once the adults have been addressed. The achievement of the desired level of competence for EMS-C in the larger system is hampered by many factors. These include lack of organization, equipment, training, and a tack of understanding of the child's unique problems and needs. In response to these needs, Congress approved a demonstration grant program in 1984. The purpose of the program was threefold: to expand access to EMS-C, to improve the quality available through existing Emergency Medical Systems (EMS), and to generate knowledge and experience that would be of use to all states and localities seeking to improve their system. Continuing interest prompted the formation of the Committee on Pediatric Emergency Medical Services by the IOM. This 19-member committee Chaired by Dr Donald N. Medearis, Jr released their report in the summer of 1993. The IOM report entitled Emergency Medical Services for Chi is available in both a soft cover 25-page summary and the full text (see Appendix).

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

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.

Emergency Medical Services Liability Litigation in the United States: 1987 to 1992

1994 ◽  
Vol 9 (4) ◽  
pp. 214-220 ◽  
Author(s):  
David L. Morgan ◽  
Michael P. Wainscott ◽  
Heidi C. Knowles
Keyword(s):  
Emergency Medical Services ◽  
The United States ◽  
Medical Services ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Trial Court ◽  
Legal Cases ◽  
Patient Transport ◽  
Emergency Medical ◽  
The Common

AbstractIntroduction:Although emergency medical services (EMS) liability litigation is a concern of many prehospital health care providers, there have been no studies of these legal cases nationwide and no local case studies since 1987.Methods:A retrospective case series was obtained from a computerized database of trial court cases filed against EMS agencies nation-wide. All legal cases that met the inclusion criteria were included in the study sample. These cases must have involved either ambulance collisions (AC) or patient care (PC) incidents, and they must have been closed between 1987 and 1992.Results:There were 76 cases that met the inclusion criteria. Half of these cases involved an AC, and the other cases alleged negligence of a PC encounter. Thirty (78.9%) of the plaintiffs in the AC cases were other motorists, and 35 (92.1%) of the plaintiffs in the PC cases were EMS patients. Almost half of the cases named an individual (usually an emergency medical technician or paramedic) as a codefendant. Thirty-one (40.8%) of the cases were closed without any payment to the plaintiff. There were five cases with plaintiffs' awards or settlements greater than [US] $1 million. Most (71.0%) ofthe ACs occurred in an intersection or when one vehicle rear-ended another vehicle. The most common negligence allegations in the PC cases were arrival delay, inadequate assessment, inadequate treatment, patient transport delay, and no patient transport.Conclusion:Risk management for EMS requires specific knowledge of the common sources of EMS liability litigation. This sample of recent legal cases provides the common allegations of negligence. Recommendations to decrease the legal risk of EMS agencies and prehospital providers are suggested.

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