Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
-
We investigated 9-1-1 telecommunicators' perceptions of communication difficulties with callers who have limited English proficiency (LEP) and the frequency and outcomes of specific communication behaviors. ⋯ Our study shows that 9-1-1 telecommunicators believe language barriers with LEP callers negatively impact communication and care outcomes. More research needs to be conducted on "best practices" for phone-based emergency communication with LEP callers. Additionally, LEP communities need to better understand the 9-1-1 system and how to effectively communicate during emergencies.
-
Prompt reperfusion in ST-segment elevation myocardial infarction (STEMI) saves lives. Although studies have shown that paramedics can reliably interpret STEMI on prehospital 12-lead electrocardiograms (p12ECGs), prehospital activation of the cardiac catheterization laboratory by emergency medical services (EMS) has not yet gained widespread acceptance. ⋯ Important reductions in time to reperfusion seem possible by activation of the catheterization laboratory by EMS from the scene, with an acceptably low false-positive rate in this small sample. This type of clinical research can inform multidisciplinary policies and bring about meaningful clinical practice changes.
-
To describe requirements of physicians wishing to function as primary field emergency medical services (EMS) providers and variation of these requirements among states. ⋯ Most states allow physicians to become certified prehospital care providers, although few states require physicians wishing to work as a primary EMS provider to do so, or even to undergo any specific EMS training. There is no national standardization of the preparatory requirements of physicians wishing to provide in-field EMS.
-
Wilderness activities continue to be popular in the United States, but may lead to both direct injuries and exacerbations or complications from chronic diseases. Appropriate response planning requires information on the type and location of emergency medical services (EMS) activations in large outdoor areas with many visitors. ⋯ EMS runs in Shenandoah are increasing and the majority of calls from 2003 to 2007 were for injuries. A notable number of patients with both injuries and illnesses reported chronic medical conditions. These data may be used to help with EMS support availability planning, provider education, and safety planning within the park, and provide baseline data for future public-safety interventions.
-
The American Heart Association's (AHA's) Advanced Cardiac Life Support guidelines act as the national standards for termination of resuscitation (TOR) in cases of refractory out-of-hospital cardiac arrest. However, local emergency medical services (EMS) implementation of these guidelines has been nonuniform. ⋯ We have identified operational barriers that may impede implementation of TOR guidelines. Three influential stakeholder groups will need to work with national organizations to overcome these local barriers.