Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Programs that seek to avoid emergency department (ED) visits from patients residing in long-term care facilities are increasing. We sought to identify existing programs where allied healthcare personnel are the primary providers of the intervention and, to evaluate their effectiveness and safety. ⋯ We found five types of programs/interventions which all demonstrated a decrease in ED visits or hospitalization. However, most studies were observational and few assessed patient safety. Many identified programs focused on increased primary care for patients, and interventions addressing acute care issues, such as community paramedics, deserve more study.
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Emergency Medical Services (EMS) often respond to 911 calls using red lights and sirens (RLS). RLS is associated with increased collisions and increased injuries to EMS personnel. While some patients might benefit from time savings, there is little evidence to guide targeted RLS response strategies. ⋯ In this large national dataset, RLS responses were very common (86%) yet potentially life-saving interventions were infrequent (6.9%). These data suggest a methodology to help EMS leaders craft targeted RLS response strategies.
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The National Association of Emergency Medicine Services (EMS) Physicians (NAEMSP) recognizes the continued growth and complexity of mass gathering events and the integral role of the medical director in their planning and management. There is a growing body of literature that provides additional insight into patient presentations as well as preparation, staffing, and planning for these events. ⋯ This updated guidance is intended for use by EMS personnel, EMS medical directors, emergency physicians, and other members of the multidisciplinary care team as they strive to provide the best care for patients in a variety of out-of-hospital environments. This document is not meant to be a complete review of all the issues on this topic, but rather a consensus statement based on the combination of available peer-reviewed, published evidence and expert opinion.
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Handoff communication between Emergency Medical Services (EMS) and Emergency Department (ED) staff is critical to ensure quality patient care. In January 2016, the Southwest Texas Regional Advisory Council (STRAC) implemented MIST (Mechanism, Injuries, vital Signs, Treatments), a standardized EMS to ED handoff tool. The En route Care Research Center conducted a Pre-MIST implementation survey of ED staff in December 2015 and a Post-MIST follow-up survey in July 2017 to determine the impact of the MIST handoff tool on the perceived quality of transmission of pertinent patient information and in the overall handoff experience. ⋯ These data demonstrate that providers and nurses reported an improvement in the handoff experience Post-MIST. This study supports the use of a standardized handoff tool at this critical step in patient care.