Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Pulseless electrical activity (PEA) arrest, which includes pseudo-PEA, is increasingly common and survival remains dismal. We hypothesized that mechanical chest compressions synchronized to native cardiac contractions improve coronary perfusion pressure (CPP) during pseudo-PEA resuscitation. ⋯ Synchronized chest compressions increased CPP 4.0 mm Hg (135%) more than unsynchronized compressions despite a lower compression rate in medication-induced pseudo-PEA. Further refinement and eventual application to patients suffering pseudo-PEA arrest appear warranted.
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Emergency medical services (EMS) post-overdose outreach programs expand beyond traditional 9-1-1 response to offer overdose survivors linkage to substance use treatment and other related harm-reducing interventions. Although intuitive and increasingly popular, evidence to define expected outcomes is exceedingly limited. We evaluated process and patient outcomes of one large Midwestern post-overdose outreach program to describe outreach characteristics and linkage to substance use treatment. ⋯ Post-overdose outreach initiated by EMS can successfully find and link individuals to substance use treatment following a non-fatal opioid overdose. However, this intervention may be resource intensive, often requiring multiple attempts at outreach and several modalities of interaction to facilitate treatment linkage.
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Personal attitudes amongst emergency medical services (EMS) clinicians could influence successful implementation of prehospital buprenorphine administration programs (PBAPs), yet few studies have investigated EMS clinician perceptions concerning these innovative programs. This mixed-methods study assessed EMS clinician perceptions and concerns about PBAPs. ⋯ Emergency medical services clinicians' perceptions towards prehospital buprenorphine administration could influence adoption of PBAP protocols. Findings may inform PBAP educational initiatives which mitigate these concerns and knowledge gaps.
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Efficient dispatching of physician-staffed vehicles in emergency medical services requires clear criteria to ensure timely allocation of resources, improve patient outcomes, and minimize response time under high-pressure conditions. The aim of this study was to identify criteria ensuring that emergency physicians are safely managed and efficiently deployed. ⋯ The results show opportunities for optimizing emergency physician dispatch. The presence of a vital sign abnormality should be given greater consideration in the future. Query algorithms for detecting cases with a high probability of requiring CL1/CL2 measures could support efficient dispatching. Furthermore, emergencies requiring CL2 but rarely CL1 measures could be handled independently by emergency paramedics, particularly if they have access to the support of a tele-emergency physician for situations where CL1 measures become necessary.
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During the COVID-19 pandemic, the number of ambulance calls increased sharply, and ambulances could not be dispatched due to unavailability, especially in rural areas. This study assessed the integration of traditional emergency care systems in rural areas with online medical services from urban areas. ⋯ Online medical services have the potential to optimize medical resource allocation and utilization in rural areas.