EMS Knowledge and Skills in Rural North Carolina: A Comparison with the National EMS Education and Practice Blueprint

1996 ◽  
Vol 11 (4) ◽  
pp. 254-260 ◽  
Author(s):  
Lawrence H. Brown ◽  
Terry W. Copeland ◽  
John E. Gough ◽  
Herbert G. Garrison ◽  
Kathleen A. Dunn
Keyword(s):  
North Carolina ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Similar Action ◽  
Knowledge And Skills ◽  
Emergency Medical ◽  
State And Local ◽  
Ems Education ◽  
National Emergency ◽  
Eastern North Carolina

AbstractIntroduction:Many state and local emergency medical services (EMS) systems may wish to modify provider levels and their scope of practice to align their systems with the recommendations of the National Emergency Medical Services Education and Practice Blueprint. To determine any changes that may be needed in a typical EMS system, the knowledge and skills of EMS providers in one rural area of North Carolina were compared with the knowledge and skills recommended in the National Emergency Medical Services Education and Practice Blueprint.Methods:A survey listing 175 items of patient care-oriented knowledge and skills described in the National Emergency Medical Services Education and Practice Blueprint was developed. EMS providers from five rural eastern North Carolina counties were asked to identify on the survey those items of knowledge and skills they believed they possessed. The skills and knowledge selected by the respondents at the five different North Carolina levels of certification were compared with the knowledge and skills listed for comparable provider levels delineated by the National Emergency Medical Services Education and Practice Blueprint. The proportions of the recommended skills reported to be possessed by the respondents were compared to determine which North Carolina certification levels best correlate with the Blueprint.Results:One hundred forty-five EMS providers completed the survey. The proportion of recommended skills and knowledge reported to be possessed by Emergency Medical Technicians (EMTs) ranked significantly lower than did the skills and knowledge reported to be possessed by respondents at other levels in five of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Defibrillator-level personnel ranked lower than did those reported to be possessed by respondents at other levels in seven of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Intermediates ranked lower than did those reported to be possessed by respondents at other levels in nine of the 10 Blueprint elements. The proportion of recommended skills and knowledge reported to be possessed by EMT-Advanced Intermediates ranked lower than were the skills and knowledge reported to be possessed by respondents at other levels in two of the 10 Blueprint elements. Finally, the proportion of recommended skills and knowledge reported to be possessed by EMT-Paramedics ranked lower than were those reported to be possessed by respondents at other levels in one of the 10 Blueprint elements.Conclusion:In North Carolina, combining the EMT and EMT-Defibrillator levels and eliminating the EMT-Intermediate level would create three levels of certification, which would be more consistent with levels recommended by the Blueprint. The results of this study should be considered in any effort to revise the levels of EMS certification in North Carolina and in planning the training curricula for bridging those levels. Other states may require similar action to align with the National Emergency Medical Services Education and Practice Blueprint.

scholarly journals Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 54S-61S
Author(s):  
Jonathan Fix ◽  
Amy I. Ising ◽  
Scott K. Proescholdbell ◽  
Dennis M. Falls ◽  
Catherine S. Wolff ◽  
...  
Keyword(s):  
Emergency Department ◽  
North Carolina ◽  
Emergency Medical Services ◽  
Data Linkage ◽  
Medical Services ◽  
Opioid Overdose ◽  
Naloxone Administration ◽  
Emergency Medical ◽  
Diagnosis Codes ◽  
Linkage Methods

Introduction Linking emergency medical services (EMS) data to emergency department (ED) data enables assessing the continuum of care and evaluating patient outcomes. We developed novel methods to enhance linkage performance and analysis of EMS and ED data for opioid overdose surveillance in North Carolina. Methods We identified data on all EMS encounters in North Carolina during January 1–November 30, 2017, with documented naloxone administration and transportation to the ED. We linked these data with ED visit data in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool. We manually reviewed a subset of data from 12 counties to create a gold standard that informed developing iterative linkage methods using demographic, time, and destination variables. We calculated the proportion of suspected opioid overdose EMS cases that received International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes for opioid overdose in the ED. Results We identified 12 088 EMS encounters of patients treated with naloxone and transported to the ED. The 12-county subset included 1781 linkage-eligible EMS encounters, with historical linkage of 65.4% (1165 of 1781) and 1.6% false linkages. Through iterative linkage methods, performance improved to 91.0% (1620 of 1781) with 0.1% false linkages. Among statewide EMS encounters with naloxone administration, the linkage improved from 47.1% to 91.1%. We found diagnosis codes for opioid overdose in the ED among 27.2% of statewide linked records. Practice Implications Through an iterative linkage approach, EMS–ED data linkage performance improved greatly while reducing the number of false linkages. Improved EMS–ED data linkage quality can enhance surveillance activities, inform emergency response practices, and improve quality of care through evaluating initial patient presentations, field interventions, and ultimate diagnoses.

Characterizing Opioid Overdoses Using Emergency Medical Services Data

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 62S-71S
Author(s):  
Josie J. Sivaraman ◽  
Scott K. Proescholdbell ◽  
David Ezzell ◽  
Meghan E. Shanahan
Keyword(s):  
Machine Learning ◽  
North Carolina ◽  
Emergency Medical Services ◽  
Expert Knowledge ◽  
Case Definition ◽  
Medical Services ◽  
Opioid Overdose ◽  
Machine Learning Classification ◽  
Emergency Medical ◽  
Definition Of

Objectives Tracking nonfatal overdoses in the escalating opioid overdose epidemic is important but challenging. The objective of this study was to create an innovative case definition of opioid overdose in North Carolina emergency medical services (EMS) data, with flexible methodology for application to other states’ data. Methods This study used de-identified North Carolina EMS encounter data from 2010-2015 for patients aged >12 years to develop a case definition of opioid overdose using an expert knowledge, rule-based algorithm reflecting whether key variables identified drug use/poisoning or overdose or whether the patient received naloxone. We text mined EMS narratives and applied a machine-learning classification tree model to the text to predict cases of opioid overdose. We trained models on the basis of whether the chief concern identified opioid overdose. Results Using a random sample from the data, we found the positive predictive value of this case definition to be 90.0%, as compared with 82.7% using a previously published case definition. Using our case definition, the number of unresponsive opioid overdoses increased from 3412 in 2010 to 7194 in 2015. The corresponding monthly rate increased by a factor of 1.7 from January 2010 (3.0 per 1000 encounters; n = 261 encounters) to December 2015 (5.1 per 1000 encounters; n = 622 encounters). Among EMS responses for unresponsive opioid overdose, the prevalence of naloxone use was 83%. Conclusions This study demonstrates the potential for using machine learning in combination with a more traditional substantive knowledge algorithm-based approach to create a case definition for opioid overdose in EMS data.

scholarly journals Emergency Medical Services Capacity for Prehospital Stroke Care in North Carolina

2013 ◽  
Vol 10 ◽  
Author(s):  
Mehul D. Patel ◽  
Jane H. Brice ◽  
Kelly R. Evenson ◽  
Kathryn M. Rose ◽  
Chirayath M. Suchindran ◽  
...  
Keyword(s):  
North Carolina ◽  
Emergency Medical Services ◽  
Stroke Care ◽  
Medical Services ◽  
Emergency Medical

scholarly journals Emergency Patients with Mental Crisis Accessing Emergency Medical Services in Thailand

2019 ◽  
Vol 34 (s1) ◽  
pp. s126-s126
Author(s):  
Porntip Wachiradilok
Keyword(s):  
Emergency Medical Services ◽  
Winter Season ◽  
Psychiatric Hospitals ◽  
Medical Services ◽  
Knowledge And Skills ◽  
Emergency Patients ◽  
Emergency Team ◽  
Emergency Medical ◽  
Number Of Patients ◽  
Insufficient Knowledge

Introduction:Emergency responders face an increasing number of calls involving people with behavioral and mental crisis issue. Integrated multi-agency schemes involving ambulance, police and mental health services are now being developed to provide urgent and emergency care pathways for these vulnerable patients.Aim:The objectives were to study the situation, characteristics, issues, and accessibility to emergency medical services (EMS) and appropriate treatment for emergency patients with a mental crisis in Thailand.Methods:The sample included 26,511 mental crisis patients accessing EMS. Data were obtained from the database of the Information Technology for Emergency Medical System between 2015-2017 and from stakeholders from four provinces distributed regionally using focus groups and in-depth interviews. The data were analyzed using descriptive statistics and content analysis.Results:The number of patients with mental crisis accessing EMS increased in the past three years. Most patients are male in the working age group from the Northeastern area during the raining and winter season, especially between September and October. During patient encounters with maniacal attacks, assistance will be requested from the police and the emergency medical units. The response depends on the experience and community capability. The emergency responder teams had insufficient knowledge and skills. Emergency rooms in most hospitals lack specific caring unit. Psychiatric hospitals have different criteria for admitting patients. Most had no fast track system and even refuse admittance.Discussion:Mental crisis patient calls with EMS were rising. However, accessibility to appropriate service centers was still an issue. Most hospitals lack prioritized access and staffs had insufficient knowledge and skills. Cooperation among the police, emergency medical operation team and the rapid psychiatric emergency team is need to be reinforced.

scholarly journals Emergency medical services core competencies: a Delphi study

2019 ◽  
Vol 16 ◽  
Author(s):  
Talal AlShammari ◽  
Paul Jennings ◽  
Brett Williams
Keyword(s):  
Saudi Arabia ◽  
Emergency Medical Services ◽  
Delphi Study ◽  
Core Competencies ◽  
Core Competency ◽  
Competency Framework ◽  
Medical Services ◽  
Rapid Improvement ◽  
Emergency Medical ◽  
Ems Education

IntroductionThe emergency medical services (EMS) education in Saudi Arabia has evolved considerably during the past decade and this rapid improvement has seen a disparity of educational approaches. Therefore, a core competency framework which aligns with the requirements of Saudi EMS education should be identified and accommodated. The aim of this study was to obtain professional group consensus on the desirable core competencies for EMS Bachelor degree graduates in Saudi Arabia in order to develop a core competency framework for Saudi Arabian EMS.MethodsA two-round Delphi method using a quantitative survey with a purposeful sampling technique of expert information-rich participants was used. The instrument comprised 40 core competency statements (rated on a 1-10 Likert scale, with 1 being ‘not important at all’ and 10 being ‘extremely important’) and an open-ended question. An international systematic scoping review and local national review informed the items in this study.ResultsAt the end of the second round, the response rate was 70%, and the sample demonstrated diversity in terms of qualifications, expertise and discipline. All core competencies achieved a majority and stability in the first and second rounds. Core competency items achieved the 75% consensus requirement.ConclusionThis study provided consensus on 41 core competencies specific to Saudi EMS industry requirements. However, the findings do not represent a definitive blueprint model for alignment into EMS curricula. Further research and statistical modelling for the core competencies are highly recommended.

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