Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
There is an absence of nationally representative data describing pediatric patients who use emergency medical services (EMS) and the factors associated with EMS use by children. This study characterizes pediatric emergency department (ED) visits for which the patient arrived by EMS and identifies factors associated with those visits using a nationally representative database. ⋯ Pediatric patients transported by EMS are more likely to have injuries and poisoning, and have higher-acuity illness than those arriving at the ED by other means. The epidemiology of pediatric EMS use may have important operational, training, and public health implications and requires further study.
-
We sought to characterize the collapse-to-9-1-1 call interval, to evaluate the frequency of pre-9-1-1 delay, and to assess whether delay is associated with decreased survival after out-of-hospital cardiac arrest (OHCA). ⋯ This method demonstrated that prehospital delay is common in OHCA and is associated with increased mortality. Measurement of pre-9-1-1 delay may improve precision of predictive models for OHCA survival.
-
As the role of emergency medical services (EMS) continues to expand, EMS physicians and medical directors require special skills and training to keep pace with the rapidly evolving subspecialty of EMS. In Canada, subspecialty training in EMS is still relatively new, and a standard national curriculum for physician EMS training does not exist. ⋯ The proposed framework and objectives are suitable for training medical students, family medicine trainees, community physicians, EM residents, and EMS fellows in Canada. The authors hope this article will serve as a guideline for residency and fellowship directors to develop their EMS training programs in a consistent manner, promote formal training for physicians involved in EMS, and help define the specific knowledge and expertise required of physicians who provide EMS medical direction in Canada.
-
Multicenter Study Comparative Study
Hospital variability of out-of-hospital cardiac arrest survival.
Previous literature has identified patient and emergency medical services (EMS) system factors that are associated with survival of out-of-hospital cardiac arrest patients. ⋯ Survival to discharge of resuscitated adult out-of-hospital cardiac arrest patients may vary by receiving hospital. A hospital's ratio of beds to nurse and several patient/case f actors are correlated with survival. Further research is warranted to investigate how this may affect resuscitation care, EMS transport policy, and research design.