Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS). ⋯ Our OEND implementation experiences across multiple Ohio EMS agencies identified several barriers, facilitators, and creative solutions that may inform future prehospital harm-reduction programs.
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This systematic review aims to determine the effectiveness of ambulance transportation versus helicopter transportation on mortality for trauma patients. ⋯ This systematic review found that adjusted analyses consistently favored air transport over ground transport. Unadjusted analyses showed no significant difference between the two modes of transport, except in specific subgroups. Further subgroup analyses revealed notable disparities between the two modalities, suggesting that these differences may be influenced by multiple factors. These findings highlight the need for further research to clarify the true impact of transport modality on trauma outcomes.
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Paramedic services face increasing challenges due to delays in patient transfer of care (TOC) at emergency departments (EDs). Prolonged TOC times directly impact paramedic services' ability to provide emergency response, though the patient and clinical factors contributing to these delays remain unclear. We examined TOC times for all transports to the ED and analyzed factors associated with prolonged TOC. ⋯ Prolonged TOC times disproportionately affect older or clinically complex patients, regardless of their acuity or need for paramedic intervention. Our findings highlight the importance for paramedic services, hospitals, and stakeholders to develop targeted care models and collaborations to reduce prolonged TOC.
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Abusive head trauma (AHT) is a leading cause of death in young children. Analyses of patient characteristics presenting to Emergency Medical Services (EMS) are often limited to structured data fields. Artificial Intelligence (AI) and Large Language Models (LLM) may identify rare presentations like AHT through factors not found in structured data. Our goal was to apply AI and LLM to EMS narrative documentation of young children to detect AHT. ⋯ AI and LLMs have high sensitivity and specificity to detect AHT-CAN in EMS free-text narratives. Words associated with physical signs of trauma are strongly associated with AHT-CAN. LLMs augmented with a list of n-grams may help EMS identify signs of trauma that aid in the detection of AHT in young children.
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To compare the effects of powered and manual stretchers on participants' perceived comfort and measured acceleration during lifting and loading operations. ⋯ In a controlled, laboratory-based setting, simulated use of manual and powered stretchers showed that powered stretchers significantly minimize patient discomfort and vibrations. This study underscores the potential for enhancing patient safety and quality of care. In conclusion, the powered stretcher is a promising tool for improving the quality and safety of patient transportation in prehospital settings.