Accuracy and Clinical Implications of Cincinnati Pre-Hospital Stroke Scale and Los Angeles Pre-Hospital Stroke Scale Use by Emergency Medical Services: A State Level Retrospective Study

Background Public health emergencies may significantly impact emergency medical services responses to cardiovascular emergencies. We compared emergency medical services responses to out‐of‐hospital cardiac arrest (OHCA) and ST‐segment‒elevation myocardial infarction (STEMI) during the 2020 COVID‐19 pandemic to 2018 to 2019 and evaluated the impact of California's March 19, 2020 stay‐at‐home order. Methods and Results We conducted a population‐based cross‐sectional study using Los Angeles County emergency medical services registry data for adult patients with paramedic provider impression (PI) of OHCA or STEMI from February through May in 2018 to 2020. After March 19, 2020, weekly counts for PI‐OHCA were higher (173 versus 135; incidence rate ratios, 1.28; 95% CI, 1.19‒1.37; P <0.001) while PI‐STEMI were lower (57 versus 65; incidence rate ratios, 0.87; 95% CI, 0.78‒0.97; P =0.02) compared with 2018 and 2019. After adjusting for seasonal variation in PI‐OHCA and decreased PI‐STEMI, the increase in PI‐OHCA observed after March 19, 2020 remained significant ( P =0.02). The proportion of PI‐OHCA who received defibrillation (16% versus 23%; risk difference [RD], −6.91%; 95% CI, −9.55% to −4.26%; P <0.001) and had return of spontaneous circulation (17% versus 29%; RD, −11.98%; 95% CI, −14.76% to −9.18%; P <0.001) were lower after March 19 in 2020 compared with 2018 and 2019. There was also a significant increase in dead on arrival emergency medical services responses in 2020 compared with 2018 and 2019, starting around the time of the stay‐at‐home order ( P <0.001). Conclusions Paramedics in Los Angeles County, CA responded to increased PI‐OHCA and decreased PI‐STEMI following the stay‐at‐home order. The increased PI‐OHCA was not fully explained by the reduction in PI‐STEMI. Field defibrillation and return of spontaneous circulation were lower. It is critical that public health messaging stress that emergency care should not be delayed.

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EMS-STARS: Emergency Medical Services “Superuser” Transport Associations: An Adult Retrospective Study

Prehospital Emergency Care ◽

10.3109/10903127.2014.936630 ◽

2014 ◽

Vol 19 (1) ◽

pp. 61-67 ◽

Cited By ~ 16

Author(s):

M. Kennedy Hall ◽

Maria C. Raven ◽

Jane Hall ◽

Clement Yeh ◽

Elaine Allen ◽

...

Keyword(s):

Retrospective Study ◽

Emergency Medical Services ◽

Medical Services ◽

Emergency Medical

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A Retrospective study of the pre-hospital trauma burden managed by the Western Cape Government Emergency Medical Services

South Afican Journal of Pre-hospital Emergency Care ◽

10.24213/2-1-4440 ◽

2021 ◽

Vol 2 (1) ◽

Author(s):

Naseef Abdullah ◽

Colleen Saunders ◽

Michael McCaul ◽

Peter Nyasulu

Keyword(s):

Retrospective Study ◽

Emergency Medical Services ◽

Medical Services ◽

Western Cape ◽

Emergency Medical

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Emergency Medical Service Use Among Latinos Aged 50 and Older in California Counties, Except Los Angeles, During the Early COVID-19 Pandemic Period

Frontiers in Public Health ◽

10.3389/fpubh.2021.660289 ◽

2021 ◽

Vol 9 ◽

Author(s):

Esmeralda Melgoza ◽

Hiram Beltrán-Sánchez ◽

Arturo Vargas Bustamante

Keyword(s):

Health Disparities ◽

Los Angeles ◽

Respiratory Distress ◽

Emergency Medical Services ◽

Service Use ◽

Prehospital Care ◽

The United States ◽

Medical Services ◽

Lower Odds ◽

Emergency Medical

The COVID-19 pandemic has disproportionately affected Latino adults aged 50 and older in California. Among adults aged 50–64, Latinos constitute approximately one-third (32%) of the population, but over half (52%) of COVID-19 cases, and more than two-thirds (64%) of COVID-related deaths as of June 2, 2021. These health disparities are also prevalent among Latinos 65 years and older who constitute 22% of the population, but 40% of confirmed COVID-19 cases and 50% of COVID-related deaths. Emergency medical services (EMS) are an essential component of the United States healthcare system and a vital sector in COVID-19 response efforts. Using data from the California Emergency Medical Services Information System (CEMSIS), this study examines racial and ethnic differences in respiratory distress related EMS calls among adults aged 50 and older in all counties except Los Angeles. This study compares the early pandemic period, January to June 2020, to the same time period in 2019. Between January and June 2019, Latinos aged 50 and older had statistically significantly lower odds of respiratory distress related EMS calls compared to Blacks, Asians, and Whites. During the early pandemic period, January to June 2020, Latinos aged 50 and older had statistically significantly lower odds of respiratory distress related EMS calls compared to Blacks but slightly higher odds compared to Whites. Differences by race/ethnicity and region were statistically significant. Understanding EMS health disparities is crucial to inform policies that create a more equitable prehospital care system for the heterogeneous population of middle aged and older adults.

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Land Suitability Analysis for Emergency Medical Services Posts along State Highways: A Case Study of California

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198118798293 ◽

2018 ◽

Vol 2672 (32) ◽

pp. 94-106 ◽

Cited By ~ 1

Author(s):

Ernest O. A. Tufuor ◽

Laurence R. Rilett ◽

Yunwoo Nam ◽

Antonio Hurtado Beltran

Keyword(s):

Los Angeles ◽

Response Time ◽

Emergency Medical Services ◽

San Francisco ◽

Combination Method ◽

Medical Services ◽

Impact Factors ◽

Specific Criterion ◽

Emergency Medical ◽

Multi Criteria Analysis

The quicker the response time of emergency medical services (EMS) to road crashes the higher the likelihood of survival. For example, the California Strategic Highway Safety Plan highlights the need to improve the response time and recognizes that 37% and 8% of the fatal crashes are 30 or more miles away from a trauma center in rural and urban areas, respectively. This paper seeks to: (1) demonstrate the viability of using spatial multi-criteria analysis in road safety management; and (2) provide a logical and consistent approach for identifying potential EMS locations. This paper adopted a multi-criteria analysis using the weighted linear combination method on raster data of various impact factors. The area selection criteria were: (1) closeness to probable road fatality locations; (2) distance from existing trauma centers; (3) proximity to existing rest stops; and (4) land availability. An EMS response time of 10 minutes, which is 3 minutes shorter than the national average, is used in this paper for demonstration purposes. Note that the specific criterion will be a function of the decision maker’s goal. The proposed methodology, which is a first step in identifying potential areas for EMS locations, was demonstrated on information from the state of California. It was found that of the 155,779 square miles of the land area studied, 24% were suitable, 7% were moderately suitable, and 69% were unsuitable for new EMS locations. In general, the rural areas along the west side freeway corridor, linking Los Angeles and San Francisco, are highly suitable.

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