Articles: emergency-medical-services.
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Abusive head trauma (AHT) is a leading cause of death in young children. Analyses of patient characteristics presenting to Emergency Medical Services (EMS) are often limited to structured data fields. Artificial Intelligence (AI) and Large Language Models (LLM) may identify rare presentations like AHT through factors not found in structured data. Our goal was to apply AI and LLM to EMS narrative documentation of young children to detect AHT. ⋯ AI and LLMs have high sensitivity and specificity to detect AHT-CAN in EMS free-text narratives. Words associated with physical signs of trauma are strongly associated with AHT-CAN. LLMs augmented with a list of n-grams may help EMS identify signs of trauma that aid in the detection of AHT in young children.
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Structured data fields, including medication fields involving naloxone, are routinely used to identify opioid overdoses in emergency medical services (EMS) data; between January 2021 and March 2024, there were approximately 1.2 million instances of naloxone administration. in the United States. To improve the accuracy of naloxone reporting, we developed methodology for identifying naloxone administration using both structured fields and unstructured patient care narratives for events documented by EMS. ⋯ An additional 115 (26.3%) patients receiving naloxone were identified by using unstructured case narratives compared to structured data. New surveillance methods that incorporate unstructured EMS narratives are critically needed to avoid substantial underestimation of naloxone utilization and enumeration of opioid overdoses.
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Opioids kill tens of thousands of patients each year. While only a fraction of people with opioid use disorder (OUD) have accessed treatment in the last year, 30% of people who died from an overdose had an Emergency Medical Services (EMS) encounter within a year of their death. Prehospital buprenorphine represents an important emerging OUD treatment, yet limited data describe barriers to this treatment. Our objectives were to quantify the number of patients encountered by EMS who were eligible for prehospital buprenorphine, and to examine characteristics of patients who did or did not receive treatment. ⋯ One-in-three EMS patients with suspected opioid use disorder were ineligible for treatment with buprenorphine due to altered mental status. The second largest group consisted of patients who were eligible but not offered buprenorphine, highlighting potential gaps in paramedic training, logistical challenges in field administrations, and other factors that warrant further exploration.
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To compare the effects of powered and manual stretchers on participants' perceived comfort and measured acceleration during lifting and loading operations. ⋯ In a controlled, laboratory-based setting, simulated use of manual and powered stretchers showed that powered stretchers significantly minimize patient discomfort and vibrations. This study underscores the potential for enhancing patient safety and quality of care. In conclusion, the powered stretcher is a promising tool for improving the quality and safety of patient transportation in prehospital settings.
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Prehospital endotracheal intubation (ETI) is a lifesaving procedure with known complications. To reduce ETI-associated morbidity and mortality, organizations prioritize first-pass success (FPS). However, there are few data evaluating the association of FPS with clinician licensure. ⋯ Critical care paramedics and nurses perform ETI with similar proficiency. In this analysis of 7,812 intubations, clinician licensure was not associated with FPS nor LPS after controlling for multiple common confounders. Further research evaluating training schemes especially in early years of experience is needed.