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) play a key role in access to prehospital emergency care. While EMS has defined levels of certification, the roles in the care paradigm fulfilled by these clinicians vary. The aim of this study is to describe the national differences between EMS clinicians with primary non-patient care vs. patient care roles. ⋯ EMS clinicians in non-patient care roles account for 17% of the study population. The odds of performing as a non-patient care practitioner are associated with characteristics related to demographics and workforce experience. Future work will be necessary to identify mechanisms to encourage diversity within the patient care and non-patient care workforces.
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Objective: A centralized transport destination officer (TDO) is one technique used by EMS systems to distribute patients. This retrospective analysis examines the effect of a TDO on simultaneous arrivals and consecutive simultaneous arrivals at emergency departments in a suburban EMS system, and their relationship to transport unit throughput. Methods: Each system hospital arrival from July 1, 2020 to February 28, 2022, at six study hospitals was evaluated. ⋯ Conclusions: A centralized EMS transport destination officer is associated with a reduction in simultaneous and consecutive simultaneous arrivals of patients in the emergency department. Further analysis also shows a significant correlation between the number of simultaneous and consecutive simultaneous arrivals and transport unit hospital turnaround interval. This technique to achieve load balancing across transport destinations appears to be effective and can be considered in systems experiencing throughput difficulties.
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The Field Triage Guidelines (FTG) are used across North America to identify seriously injured patients for transport to appropriate level trauma centers, with a goal of under-triaging no more than 5% and over-triaging between 25% and 35%. Our objective was to systematically review the literature on under-triage and over-triage rates of the FTG. ⋯ Evidence suggests that under-triage, while improved if the FTG is strictly applied, remains above targets, with higher rates of under-triage in both children and older adults.
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Meta Analysis
Non-invasive ventilation in the prehospital emergency setting: A systematic review and meta-analysis.
Noninvasive ventilation is a well-established treatment for acute respiratory failure, being increasingly applied in the prehospital setting. This systematic review and meta-analysis aims to investigate whether early prehospital initiation of noninvasive ventilation reduces mortality compared to standard oxygen therapy. ⋯ PROSPERO CRD42021284947.