Prehospital emergency providers (emergency medical technicians [EMTs] and paramedics) who respond to calls for patients near the end of life (EOL) make critical decisions in field about initiating care transport an department.To identify how a sample prehospital learned EOL care, their perceived confidence with perspectives on improved preparation such calls.This descriptive study used cross-sectional survey design mixed methods.One hundred seventy-eight (76 EMT-basics 102 from services...

Abstract Background Abuse or unintended overdose (OD) of opiates and heroin may result in prehospital emergency department (ED) care. Prehospital naloxone use has been suggested as a surrogate marker community opiate ODs. The study objective was to verify externally whether is ODs by comparing Emergency Medical Services (EMS) administration records an independent database ED visits for the same community. Methods A retrospective chart review data from July 2009 through June 2013 conducted....

The nature of emergency end-of-life calls is changing as people live longer and die from chronic illnesses. This study explored prehospital providers’ perceptions (1) 911 calls, (2) the signs symptoms dying, (3) medical orders for life sustaining treatment (MOLST). exploratory–descriptive pilot was survey based cross-sectional. Calls to nursing homes occur most often, (47.8% every shift). MOLST seen infrequently (57.9% rarely never). frequent dying were diagnosis (76%), hospice involvement...

Abstract Objective St. Paul's Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1‐hour observation period following naloxone administration for opiate overdose. The rule suggested that if they mobilize as usual and had normal oxygen saturation, respiratory rate, temperature, heart Glasgow Coma Scale score. Validation of is necessary ensure these criteria are appropriate apply presenting an unintentional presumed...

Abstract Objectives Rapid identification of esophageal intubations is critical to avoid patient morbidity and mortality. Continuous waveform capnography remains the gold standard for endotracheal tube (ETT) confirmation, but it has limitations. Point-of-care ultrasound (POCUS) may be a useful alternative confirming ETT placement. The objective this study was determine accuracy paramedic-performed POCUS with without manipulation. Methods A prospective, observational using cadaver model...

Understanding the factors associated with attracting women to a residency program would help leadership build programs that are appealing candidates. The objective of this study was identify percentage residents in emergency medicine (EM) programs.A list 161 Accreditation Council for Graduate Medical Education-approved EM residencies compiled. public websites each queried information on following variables: region (Midwest, Northeast, South, West), length (3 years vs. 4 years), sex...

Abstract Introduction High-dose intravenous nitroglycerin is a common in-hospital treatment for respiratory distress due to congestive heart failure (CHF) with hypertension. Intravenous (IV) administration impractical in the prehospital setting. In 2011, new regional Emergency Medical Services (EMS) protocol was introduced allowing advanced providers treat CHF high-dose oral nitroglycerin. The calls patients be treated two sublingual tabs (0.8 mg) when systolic blood pressure (SBP) >160...

Most Emergency Medical Services (EMS) protocols require spine immobilization with both a cervical collar and long board for patients suspected injuries. The goal of this research was to determine the prevalence unstable thoracolumbar injuries among receiving prehospital immobilization: 4-year retrospective review adult subjects who received were transported trauma center. Prehospital hospital records linked. Data reviewed if imaging ordered, whether acute fractures, dislocations, or...

Paramedics often intubate in challenging environments. We evaluated whether patient position might affect prehospital intubation success rates utilizing a cadaver model.The study was conducted two phases: cross-sectional survey and an experimental model which paramedics were asked to demonstrate skills on cadavers three positions. New York State certified paid volunteer critical care emergency medical technicians recruited from multiple agencies. To assess past experience, participants...

Over the past decade, Emergency Medical Service (EMS) systems decreased backboard use as they transition from spinal immobilization (SI) protocols to motion restriction (SMR) protocols. Since this change, no study has examined its effect on neurologic outcomes of patients with spine injuries.The object is determine if a state-wide protocol change an SI SMR had incidence disabling cord injuries.This was retrospective review in single Level I trauma center before and after injury A two-step...

Abstract Introduction Specialized knowledge and a scientific body of literature are the foundation recognition Emergency Medical Services (EMS) as subspecialty within emergency medicine (EM). research often is presented at national meetings published in abstract form, but full publication occurs less frequently. Problem The primary goal study was to determine rate which EMS-related selected conferences went on manuscript publication. A secondary determination time Methods cross-sectional...

Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers suspect a spinal injury when none exists resulting additional imaging of the thoracolumbar spine. New York had previously employed "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected injuries. In 2015, instituted new Motion Restriction" made use optional these The objective this study was...

Diazepam and midazolam are commonly used by paramedics to treat seizures. A period of drug scarcity was as an opportunity compare their effectiveness in treating prehospital seizures.A retrospective chart review a single, large, commercial agency during 29-month performed. The included alternating shortages both medications. Ambulances were stocked with either diazepam or based on availability the drugs. Adult patients who received at least 1 parenteral dose for treatment seizures included....