Vaccination Against Seasonal or Pandemic Influenza in Emergency Medical Services

2016 ◽  
Vol 31 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Alexandre Moser ◽  
Cédric Mabire ◽  
Olivier Hugli ◽  
Victor Dorribo ◽  
Giorgio Zanetti ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Pandemic Influenza ◽  
Work Experience ◽  
Good Health ◽  
Vaccination Rate ◽  
Vaccination Status ◽  
Medical Services ◽  
Publication Type ◽  
Vaccination Rates ◽  
Emergency Medical

AbstractIntroductionInfluenza is a major concern for Emergency Medical Services (EMS); EMS workers’ (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting.HypothesisThe influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated.MethodsA survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected.ResultsResponse rate was 95%. The EMS-Ws were predominantly male (n=45; 73%), in good health (87%), with a mean age of 36 (SD=7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI+/SI+), 19% for PI only (PI+/SI-), 1.6% for SI only (PI-/SI+), and 39% were not vaccinated against either (PI-/SI-). Women’s vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI+/SI+ EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI- (P=.001) and 25% for PI+/SI- (P=.001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P=.001). Thirty percent of the PI+/SI+ EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI- and PI+/SI- groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness.ConclusionAverage vaccination rate in this study’s EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a “pandemic effect.” These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.MoserA, MabireC, HugliO, DorriboV, ZanettiG, Lazor-BlanchetC, CarronPN. Vaccination against seasonal or pandemic influenza in Emergency Medical Services. Prehosp Disaster Med. 2016;31(2):155–162.

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study

2018 ◽  
Vol 34 (1) ◽  
pp. 38-45
Author(s):  
Mazen El Sayed ◽  
Chady El Tawil ◽  
Hani Tamim ◽  
Aurelie Mailhac ◽  
N. Clay Mann
Keyword(s):  
Law Enforcement ◽  
Emergency Medical Services ◽  
Life Support ◽  
Salt Lake ◽  
Traumatic Injury ◽  
Medical Services ◽  
National Study ◽  
Publication Type ◽  
Excessive Heat ◽  
Emergency Medical

AbstractBackgroundConducted electrical weapons (CEWs), including Thomas A. Swift Electric Rifles (TASERs), are increasingly used by law enforcement officers (LEOs) in the US and world-wide. Little is known about the experience of Emergency Medical Service (EMS) providers with these incidents.ObjectivesThis study describes EMS encounters with documented TASER use and barb removal, characteristics of resulting injuries, and treatment provided.MethodsThis retrospective study used five combined, consecutive National Emergency Medical Services Information System (NEMSIS; Salt Lake City, Utah USA) public-release datasets (2011-2015). All EMS activations with documented TASER barb removal were included. Descriptive analyses were carried out.ResultsThe study included 648 EMS activations with documented TASER barb removal, yielding a prevalence rate of 4.55 per 1,000,000 EMS activations. Patients had a mean age of 35.9 years (SD=18.2). The majority were males (80.2%) and mainly white (71.3%). Included EMS activations were mostly in urban or suburban areas (78.3%). Over one-half received Advanced Life Support (ALS)-level of service (58.2%). The most common chief complaint reported by dispatch were burns (29.9%), followed by traumatic injury (16.1%). Patients had pain (45.6%) or wound (17.2%) as a primary symptom, with most having possible injury (77.8%). Reported causes of injury were mainly fire and flames (29.8%) or excessive heat (16.7%). The provider’s primary impressions were traumatic injury (66.3%) and behavioral/psychiatric disorder (16.8%). Only one cardiac arrest (0.2%) was reported. Over one-half of activations resulted in patient transports (56.3%), mainly to a hospital (91.2%). These encounters required routine EMS care (procedures and medications). An increase in the prevalence of EMS activations with documented TASER barb removal over the study period was not significant (P=.27).ConclusionAt present, EMS activations with documented TASER barb removal are rare. Routine care by EMS is expected, and life-threatening emergencies are not common. All EMS providers should be familiar with local policies and procedures related to TASER use and barb removal.El SayedM, El TawilC, TamimH, MailhacA, MannNC. Emergency Medical Services experience with barb removal after TASER use by law enforcement: a descriptive national study. Prehosp Disaster Med. 2019;34(1):38–45.

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 Why do Emergency Medical Services (EMS) Professionals Leave EMS?

2016 ◽  
Vol 31 (S1) ◽  
pp. S105-S111 ◽  
Author(s):  
Gary Blau ◽  
Susan A. Chapman
Keyword(s):  
Emergency Medical Services ◽  
Further Education ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Publication Type ◽  
Exit Survey ◽  
Emergency Medical ◽  
Exit Decisions ◽  
New Location ◽  
Medical Technician

AbstractObjectiveThe objective was to determine why Emergency Medical Technician (EMT)-Basics and Paramedics leave the Emergency Medical Services (EMS) workforce.MethodsData were collected through annual surveys of nationally registered EMT-Basics and Paramedics from 1999 to 2008. Survey items dealing with satisfaction with the EMS profession, likelihood of leaving the profession, and likelihood of leaving their EMS job were assessed for both EMT-Basics and Paramedics, along with reasons for leaving the profession. Individuals whose responses indicated that they were not working in EMS were mailed a special exit survey to determine the reasons for leaving EMS.ResultsThe likelihood of leaving the profession in the next year was low for both EMT-Basics and Paramedics. Although overall satisfaction levels with the profession were high, EMT-Basics were significantly more satisfied than Paramedics. The most important reasons for leaving the profession were choosing to pursue further education and moving to a new location. A desire for better pay and benefits was a significantly more important reason for EMT-Paramedics’ exit decisions than for EMT-Basics.ConclusionsGiven the anticipated increased demand for EMS professionals in the next decade, continued study of issues associated with retention is strongly recommended. Some specific recommendations and suggestions for promoting retention are provided.BlauG, ChapmanSA. Why do Emergency Medical Services (EMS) professionals leave EMS?Prehosp Disaster Med. 2016;31(Suppl. 1):s105–s111.

scholarly journals Clinical competencies of emergency medical services paramedics in responding to emergency conditions using Objective Structured Clinical Examination (OSCE) in Guilan

2021 ◽  
Vol 7 (2) ◽  
pp. 101-105
Author(s):  
Arash Amirrafiei ◽  
Seyyed Mahdi Zia Ziabari ◽  
Fatemeh Haghshenas-Bakerdar ◽  
Ehsan Kazemnejad-Leili ◽  
Payman Asadi
Keyword(s):  
Emergency Medical Services ◽  
Clinical Examination ◽  
Content Validity ◽  
Work Experience ◽  
Clinical Skills ◽  
Statistical Tests ◽  
Objective Structured Clinical Examination ◽  
Medical Services ◽  
Clinical Competencies ◽  
Emergency Medical

Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.

1st Attempt Success Rate of Ultrasound-Guided Peripheral IV Access of Emergency Medical Services Health Care Providers on the Pre-Hospital Simulation Model

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S35-S39
Keyword(s):  
Health Care ◽  
Simulation Model ◽  
Emergency Medical Services ◽  
Success Rate ◽  
Health Care Providers ◽  
Work Experience ◽  
Medical Services ◽  
Care Providers ◽  
Ultrasound Guided ◽  
Emergency Medical

Background: Ultrasound guided peripheral intravenous access (USGPIV) has derived benefits for the Emergency and Pre-hospital Management. However, no studies have yet been conducted that have focused upon Emergency Medical Services (EMS) personnel in Thailand. Objective: To introduce USGPIV cannulation to the health care providers of Emergency Medical Services and to examine the success rates of the first attempts at PIV cannulation. Materials and Methods: This prospective observational study was conducted with 49 EMS providers in August 2020. All respondents had been participants in a USGPIV workshop. Afterwards, the participants’ skills were evaluated in a Pre-hospital simulation model, which was conducted in a moving ambulance. The data, which was recorded, noted the number of attempts required to successfully obtain USGPIV access, as well as the participants’ opinions about using ultrasound in this procedure. Results: Among the 49 participants, the first attempt success rate was found to be at 57.14%. The participants’ genders, their years of work experience, their experience of performing PIV with real patients, and the categories of the Emergency Medical Services health care providers were determined not to be factors that had contributed to the success rate of the first attempts at USGPIV. Our study demonstrated a “High” level of satisfaction with regard to performing USGPIV with this ultrasound device (4 out of 5). However, the participants noted that some elements of the environment in the ambulance may have affected the success rate of performing this procedure. Conclusion: In this study, the success rate of the first attempts was found to be lower than in other studies. However, in regard to this simulation, implementing this procedure represents the first step towards assisting Thai EMS personnel to perform ultrasound procedures. Keywords: Ultrasound, Peripheral IV cannulation, Emergency medicine, Emergency medical services, Emergency medical personnel

scholarly journals Stop Stroke: A Brief Report on Door-to-Needle Times and Performance After Implementing an Acute Care Coordination Medical Application and Implications to Emergency Medical Services

2017 ◽  
Vol 32 (3) ◽  
pp. 343-347 ◽  
Author(s):  
Robert Dickson ◽  
Adrian Nedelcut ◽  
Melissa McPeek Nedelcut
Keyword(s):  
Emergency Medical Services ◽  
Acute Care ◽  
Care Coordination ◽  
Medical Application ◽  
Medical Services ◽  
Secondary Outcome ◽  
Publication Type ◽  
Emergency Medical ◽  
Number Of Patients ◽  
And Performance

AbstractObjectiveThe objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS).MethodsThis was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period. The primary outcome was mean DTN times before and after initiating Stop Stroke. Secondary outcome was the effect on the DTN≤60-minute benchmark.ResultsDuring the study period, there were 533 stroke activations (200 before Stop Stroke implementation and 333 after). A total of 68 patients meeting inclusion criteria were analyzed (34 pre-app and 34 post- app). The observed mean DTN times post-app decreased 21 minutes (77 to 56 minutes), a 28% improvement (P=.001). Further, the patients meeting DTN≤60 minutes improved from 32% (11 of 34) to 82% (28 of 34) after the app’s implementation.ConclusionsIn this cohort of patients with AIS, Stop Stroke improved mean DTN times and number of patients treated within 60 minutes of arrival. These results demonstrate the app’s effect of increasing awareness of suspected AIS and improving coordination of care, evidenced by the magnitude of its effect on treatment times.DicksonR, NedelcutA, McPeek NedelcutM. Stop Stroke: a brief report on door-to-needle times and performance after implementing an acute care coordination medical application and implications to Emergency Medical Services. Prehosp Disaster Med. 2017;32(3):343–347.

US Emergency Medical Services Fellows

2018 ◽  
Vol 33 (3) ◽  
pp. 339-341 ◽  
Author(s):  
Brian Clemency ◽  
Christian Martin-Gill ◽  
Nicole Rall ◽  
Dipesh Patel ◽  
Jeffery Myers
Keyword(s):  
Emergency Medical Services ◽  
Fellowship Training ◽  
Medical Services ◽  
Direct Patient Care ◽  
Clinical Aspects ◽  
Cross Sectional Survey ◽  
Publication Type ◽  
Cross Sectional ◽  
Emergency Medical ◽  
Primary Reference

AbstractIntroductionThe 2015-2016 academic year was the fourth year since the Accreditation Council for Graduate Medical Education (ACGME; Chicago, Illinois USA) accredited Emergency Medical Services (EMS) fellowships, and the first year an in-training examination was given. Soon, ACGME-accredited fellowship education will be the sole path to EMS board certification when the practice pathway closes after 2019. This project aimed to describe the current class of EMS fellows at ACGME-accredited programs and their current educational opportunities to better understand current and future needs in EMS fellowship education.MethodsThis was a cross-sectional survey of EMS fellows in ACGME-accredited programs in conjunction with the first EMS In-Training Examination (EMSITE) between April and June 2016. Fellows completed a 14-question survey composed of multiple-choice and free-response questions. Basic frequency statistics were performed on their responses.ResultsFifty fellows from 35 ACGME-accredited programs completed the survey. The response rate was 100%. Forty-eight (96%) fellows reported previous training in emergency medicine. Twenty (40%) were undergoing fellowship training at the same institution as their prior residency training. Twenty-five (50%) fellows performed direct patient care aboard a helicopter during their fellowship. Thirty-three (66%) fellows had a dedicated physician response vehicle for fellows. All fellows reported using the National Association of EMS Physicians (NAEMSP; Overland Park, Kansas USA) textbooks as their primary reference. Fellows felt most prepared for the Clinical Aspects questions and least prepared for Quality Management and Research questions on the board exam.ConclusionThese data provide insight into the characteristics of EMS fellows in ACGME-accredited programs.ClemencyB, Martin-GillC, RallN, PatelD, MyersJ. US Emergency Medical Services fellows. Prehosp Disaster Med. 2018;33(3):339–341.

scholarly journals Preparedness of Finnish Emergency Medical Services for Chemical Emergencies

2016 ◽  
Vol 31 (4) ◽  
pp. 392-396 ◽  
Author(s):  
Timo J. Jama ◽  
Markku J. Kuisma
Keyword(s):  
Emergency Medical Services ◽  
Inhaled Corticosteroids ◽  
University Hospital ◽  
Medical Services ◽  
Central Hospital ◽  
Publication Type ◽  
Hospital District ◽  
Emergency Medical ◽  
Chemical Accident ◽  
Number Of Patients

AbstractIntroductionThe preparedness level of Finnish Emergency Medical Services (EMS) for treating chemical emergencies is unknown. The aim of this study was to survey the preparedness level of EMS systems for managing and handling mass-casualty chemical incidents in the prehospital phase in Finland.HypothesisThe study hypothesis was that university hospital districts would have better clinical capability to treat patients than would central hospital districts in terms of the number of patients treated in the field within one hour after dispatching as well as patients transported to hospital within one hour or two hours after dispatching.MethodsThis cross-sectional study was conducted as a Webropol (Wuppertal, Germany) survey. All hospital districts (n=20) in continental Finland were asked about their EMS preparedness level in terms of capability of treating and transporting chemically affected patients in the field. Their capability for decontamination of affected patients in the field was also inquired.ResultsUniversity hospital district-based EMS systems had at least 20% better absolute clinical capacity than central hospital-based EMS systems for treating chemically affected patients concerning all treatments inquired about, except the capacity for non-invasive ventilation (NIV)/continuous positive airway pressure (CPAP) treatment in the field. Overall, there was a good level of preparedness for treating chemical accident patients with supplemental oxygen, bronchodilators, and inhaled corticosteroids. Preparedness for providing antidote therapy in cases of cyanide gas exposure was, in general, low. The variation among the hospital districts was remarkable. Only nine of 15 central hospital district EMS had a mobile decontamination unit available, whereas four of five university hospital districts had one.ConclusionEmergency Medical Services capacity in Finland for treating chemically affected patients in the field needs to be improved, especially in terms of antidote therapy. Mobile decontamination units should be available in all hospital districts.JamaTJ, KuismaMJ. Preparedness of Finnish Emergency Medical Services for chemical emergencies. Prehosp Disaster Med. 2016;31(4):392–396.

Emergency Medical Services in India: The Present and Future

2014 ◽  
Vol 29 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Mohit Sharma ◽  
Ethan S. Brandler
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Emergency Medical ◽  
Trauma Service ◽  
Care System

AbstractIndia is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.SharmaM, BrandlerES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):1-4.

Ethical Considerations in Embedding a Surgeon in a Military or Civilian Tactical Team

2012 ◽  
Vol 27 (6) ◽  
pp. 583-588 ◽  
Author(s):  
Lewis J. Kaplan ◽  
Mark D. Siegel ◽  
Alexander L. Eastman ◽  
Lisa M. Flynn ◽  
Stanley H. Rosenbaum ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Police Officer ◽  
Police Officers ◽  
Medical Services ◽  
Medical Support ◽  
Ethical Considerations ◽  
Publication Type ◽  
Emergency Medical

AbstractTactical emergency medical services (TEMS) bring immediate medical support to the inner perimeter of special weapons and tactics team activations. While initially envisioned as a role for an individual dually trained as a police officer and paramedic, TEMS is increasingly undertaken by physicians and paramedics who are not police officers. This report explores the ethical underpinnings of embedding a surgeon within a military or civilian tactical team with regard to identity, ethically acceptable actions, triage, responsibility set, training, certification, and potential future refinements of the role of the tactical police surgeon.KaplanLJ, SiegelMD, EastmanAL, FlynnLM, RosenbaumSH, ConeDC, BlakeDP, MulhernJ. Ethical considerations in embedding a surgeon in a military or civilian tactical team. Prehosp Disaster Med. 2012;27(6):1-6.

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