Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Preventable harm from medical care has been extensively documented in the inpatient setting. Emergency medical services (EMS) providers care for patients in dynamic and challenging environments; prehospital emergency care is a field that represents an area of high risk for errors and harm, but has received relatively little attention in the patient safety literature. ⋯ We found a paucity of scientific literature exploring patient safety in EMS. Research is needed to improve our understanding of problem magnitude and threats to patient safety and to guide interventions.
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To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among emergency medical services (EMS) workers. ⋯ In this sample of EMS workers, poor sleep quality and fatigue are common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes.
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Comparative Study
Estimating core temperature with external devices after exertional heat stress in thermal protective clothing.
Temperature measurement is important for emergency medical services (EMS) providers when identifying and treating heat illness or infection. Direct measures of body core temperature (T(c)) are often expensive (ingestible capsules) or impractical (rectal probes) in the field. Multiple devices for estimating T(c) have been adopted by EMS providers, with little understanding of the agreement between these devices and T(c). ⋯ External measuring devices failed to accurately predict T(c) in hyperthermic individuals following exertion. Confidence intervals around the bias were too large to allow for reasonable estimation of T(c). EMS providers should exercise caution when using any of these temperature estimation techniques.
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Air medical transport provides rapid transport to definitive care. Overtriage and the expense and risk of transport may offset survival benefits. ⋯ Very few prehospital criteria were associated with clinically important outcomes in helicopter-transported patients. Evidence-based guidelines for the most appropriate utilization of air medical transport need to be further evaluated and developed for injured patients.
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Medication dosing errors occur in up to 17.8% of hospitalized children. There are limited data to describe pediatric medication errors by emergency medical services (EMS) paramedics. It has been shown that paramedics have infrequent encounters with pediatric patients. ⋯ Medications delivered in the prehospital care of children were frequently administered outside of the proper dose range when compared with patient weights recorded in the prehospital medical record. EMS systems should develop strategies to reduce pediatric medication dosing errors.