Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
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Emergency Medical Services (EMS) and law enforcement (LE) frequently work as a team in encounters with individuals experiencing acute behavioral emergencies manifesting with severe agitation and aggression. The optimal management is a rehearsed, coordinated effort by law enforcement and EMS providing the necessary interventions to address behaviors that endanger the patient, the responders, and the public. ⋯ A coordinated and unified response enhances the safety and effective management of potentially serious situations posed by individuals experiencing such acute behavioral emergencies. This paper provides the framework for an approach endorsed by NAEMSP, IACP, and the IAFC.
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Current guidelines recommend that patients presenting with ST-elevation myocardial infarction (STEMI) to hospitals not capable of performing primary percutaneous coronary intervention (PCI) be transferred to a PCI-capable hospital if reperfusion can be accomplished within 120 min. Most STEMI patients are accompanied by an advanced care paramedic (ACP, equivalent to EMT-P), nurse, or physician who can manage complications should they arise. In our region, stable STEMI patients are transported by primary care paramedics (PCPs, similar scope of practice to advanced EMT) in cases where a nurse, physician, or ACP paramedic is not available. Our goal was to describe adverse events and need for advanced interventions among initially stable STEMI patients during interfacility transfer by PCPs. ⋯ We found PCP-interfacility transport of initially stable STEMI patients was safe and associated with a moderate proportion of adverse events, the majority of which did not require an advanced care intervention. These findings may help decision-making to avoid delays transferring stable patients to PCI-capable centers.
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Introduction: Emergency medical services (EMS) fellowship program accreditation in the United States began in 2013, and the number of available programs has rapidly expanded since then with a corresponding increase in the number of fellows. Despite this increase in program number and attendance, there is a paucity of data in the literature reviewing personal and professional characteristics of the fellows, their experiences during fellowship, or understanding of their intended desires from fellowship. Methods: This study surveyed 2020-21 and 2021-22 EMS fellows regarding their personal and professional characteristics, motivations for program choice, remaining school debt, and the effects of COVID-19 on their training. ⋯ Conclusions: The demographics and graduate's level of preparedness appear similar to those reported from 2016, and reflect the demographics of emergency medicine residents. Other new information including desired program qualities and offerings is potentially useful for program directors. COVID-19 did appear to have a small effect on fellow's actions and possibly on ease of post-graduation employment.
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Emergency medical services (EMS) clinicians demonstrate a high prevalence of chronic medical conditions that place them at risk for early mortality. Workplace health promotion programs improve health outcomes, but the availably of such programs for EMS clinicians has not been described. We investigate the availability, scope, and participation of workplace health promotion programs available to EMS clinicians in North Carolina (NC). ⋯ While most agencies offer at least one element of a worksite health promotion program, few agencies offer all elements and participation rates are low.
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To compare emergency medical services (EMS) utilization between culturally and linguistically diverse (CALD) and non-CALD patients in Victoria, Australia. ⋯ The CALD patients used EMS less frequently than non-CALD patients with significant variation observed across age groups, countries of birth, and clinical presentation. Further research is needed to understand the factors that may be contributing to these disparities.