Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Objective: EMS clinicians work in shifts to provide 24-hour care. Shift work is linked with metabolic disease and over 70% of EMS clinicians report having overweight or obesity. Inability to store food in their vehicles combined with limited overnight dining establishments, and unpredictable job demands leads to reliance on convenience and fast foods. ⋯ Night shift workers had fewer steps (p = 0.045), more sedentary time (p = 0.053), and less moderate activity (p = 0.037) during a shift compared to day workers. Conclusion: Among EMS clinicians, night shift is associated with greater energy intake, and decreased physical activity during shifts. This may contribute to positive energy balance and weight gain overtime, increasing risk for metabolic disease.
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Introduction: One of the six guiding principles of the EMS Agenda 2050 is to foster a socially equitable care delivery system. A specific recommendation within this principle is that "local EMS leadership, educators and clinicians [should] reflect the diversity of their communities." Research has shown that women comprise a minority of emergency medicine services (EMS) field clinicians. In academic settings, women are represented at lower rates among experienced EMS faculty than within Emergency Medicine clinicians or faculty at large. ⋯ Thematic evaluation of the qualitative responses showed that respondents felt there were fewer barriers to mentorship and professional advancement opportunities in local work versus national engagement. Conclusions: In a survey evaluating representation of female professionals in EMS, participants reported on their career representations, and experiences of gender-based inequity within their EMS career settings. Several opportunities exist to improve diversity, equity, and inclusion for women in EMS based on our findings.
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Background: Early during the COVID-19 pandemic, Emergency Medical Services (EMS) systems encountered many challenges that prompted crisis-level strategies. Maryland's statewide EMS system implemented the Viral Syndrome Pandemic Triage Protocol which contained a decision tool to help identify patients potentially safe for self-care at home. Objectives: This study assessed the effects of the Maryland Viral Syndrome Pandemic Triage Protocol and the safety of referring patients for self-care at home. ⋯ The 95% CIs of the estimated effect of Triage/No Triage protocol documented were wide and crossed the 1.0 limit but overall, all effects Odds Ratios and Adjust Odds Ratios were consistently over 1.0 with the lowest value of 1.3 and the highest value of 2.1. Conclusion: Most patients (95%) who were triaged to self-care at home with home documented decision support tool use did not require hospitalization within 24 hours following EMS encounter and this appears to be safe. Future opportunity exists to incorporate such tools into comprehensive pandemic preparedness strategies along with appropriate follow up and quality improvement mechanisms.
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Objective: To assess comparative benefits and harms across three airway management approaches (bag valve mask [BVM], supraglottic airway [SGA], and endotracheal intubation [ETI]) used by prehospital emergency medical services (EMS) to treat patients with trauma, cardiac arrest, or medical emergencies, and how they differ based on techniques and devices, EMS personnel and patient characteristics. Data sources: We searched electronic citation databases (Ovid® MEDLINE®, CINAHL®, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and Scopus®) from 1990 to September 2020. Review methods: We followed Agency for Healthcare Research and Quality Effective Health Care Program Methods guidance. ⋯ Conclusions: The currently available evidence does not indicate benefits of more invasive airway approaches based on survival, neurological function, ROSC, or successful airway insertion. Strength of evidence was low or moderate; most included studies were observational. This supports the need for high-quality randomized controlled trials to advance clinical practice and EMS education and policy, and improve patient-centered outcomes.
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Introduction: The quality of an Emergency Medical Technician (EMT) or paramedic training program is likely one factor that contributes to a candidate's success on the National Registry Cognitive Examination. However, program pass rates and their associated geographic location have not previously been evaluated. Our objective was to evaluate the performance of EMT and paramedic programs in the United States, pass rates on the National Registry Cognitive Examinations, and relationship to geography. ⋯ Graduates from larger EMT and paramedic programs have higher first and cumulative third attempt pass rates compared to graduates from smaller programs. Additionally, there is variability in program pass rates across NASEMSO regions for both certification levels. Further evaluation is necessary to better understand the variability in program performance in the United States.