Prehospital Emergency Care最新文献

{"title":"Admission Hypothermia in Trauma Patients Undergoing Prehospital Tracheal Intubation: 15-Year Review of a Level-1 Trauma Center.","authors":"Manuel F Struck, Alexander Nündel, Holger Kirsten, Falk Kaiser, Silke Zimmermann, Natalia Thriemer, Robert Werdehausen, Annette Keß, Christian Kleber, Gunther Hempel","doi":"10.1080/10903127.2025.2558865","DOIUrl":"10.1080/10903127.2025.2558865","url":null,"abstract":"<p><strong>Objectives: </strong>The adverse role of accidental hypothermia in trauma patients has been studied for decades while patients undergoing prehospital tracheal intubation are at particular risk due to impaired temperature autoregulation. The primary objective of the study was to determine the prevalence and risk factors associated with admission hypothermia (body temperature <35 °C) at the emergency department. Secondary objectives included the assessment of the association of hypothermia with all-cause mortality, transfusion requirement, intensive care unit length of stay (ICU LOS), and duration of mechanical ventilation.</p><p><strong>Methods: </strong>In a single-center retrospective analysis, trauma patients aged ≥16 years undergoing prehospital tracheal intubation were analyzed for admission temperature between 2008 and 2022. Multivariable logistic regression analyses and linear regression analyses were used to examine the association between risk factors, hypothermia, and outcomes.</p><p><strong>Results: </strong>A total of 851 patients (72% male) with a median age of 50 years, a median injury severity score (ISS) of 27 points, and a 30-day mortality of 30% were included. The median admission body temperature was 35.1 °C, and 366 patients (43%) were hypothermic. Independent risk factors for hypothermia were outside temperature (OR 1.03 per one degree Celsius decrease, 95% CI 1.01 to 1.05), helicopter transport (OR 2.36, 95% CI 1.68 to 3.33), ISS score (OR 1.03, 95% CI 1.01 to 1.04), admission shock (OR 3.48, 95% CI 2.27 to 5.34), admission acidosis (OR 1.69, 95% CI 1.04 to 2.73), and admission coagulopathy (OR 1.85, 95% CI 1.25 to 2.76). Multivariable outcome analyses revealed significant associations of hypothermia with 24-h mortality (OR 6.6, 95% CI 3.2 to 13.64), 30-day mortality (OR 3.81, 95% CI 2.35 to 6.18), massive transfusion (OR 2.94, 95% CI 1.78 to 4.86), ICU LOS in survivors (beta weight 3.15, 95% CI 0.73 to 5.58) and duration of mechanical ventilation in survivors (beta weight 2.65, 95% CI 0.89 to 4.41).</p><p><strong>Conclusions: </strong>The present findings suggest that a significant proportion of trauma patients who require prehospital tracheal intubation experience hypothermia, which is associated with critical injury severity and high mortality rates. These associations suggest the potential for implementing preventive measures and rewarming strategies until arrival at the emergency department, necessitating further investigation.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate Partner Violence and Paramedicine: An Updated Scoping Review of Perspectives and Practices.","authors":"Jeremy R Caspell, Keilin Gorman, Tori N Stranges, Jasmyn Loo, Isaac J Kool, Paul van Donkelaar, Rory A Marshall","doi":"10.1080/10903127.2025.2564841","DOIUrl":"https://doi.org/10.1080/10903127.2025.2564841","url":null,"abstract":"<p><strong>Objectives: </strong>Intimate partner violence (IPV) is increasingly being recognized as a clinical circumstance to which emergency medical services (EMS) clinicians attend; it refers to the use of physical, sexual, psychological, and coercive violence by a current or former intimate partner to exert power and control. The intersection of paramedicine and IPV remains largely unclear. Our objective is to provide a comprehensive synthesis of the available evidence at the intersection of paramedicine and IPV.</p><p><strong>Methods: </strong>This review followed a published protocol (Open Science Framework), and PRISMA-ScR guidelines. Co-developed with two trained librarians, a search strategy was used to locate potential articles in MEDLINE and CINAHL, including a gray literature search. Included articles examined perceptions and/or practice of EMS clinicians and students in the context of IPV. Titles and abstracts were screened by two reviewers, followed by full text reviews when eligible; a third reviewer resolved any disagreement(s). Data were extracted using a purpose-built template and the findings were summarized and synthesized.</p><p><strong>Results: </strong>Of the 517 articles, 34 met inclusion criteria. The literature was varied and heterogenous, preventing mass, detailed synthesis. Generally, EMS clinicians were motivated to assist IPV survivors but perceived their education as insufficient to provide high-quality care, reporting low rates of training/education with corresponding low self-efficacy. Considerations for the specific and unique environment of paramedicine were lacking. Standardized patients and/or simulations were beneficial for pre-practice students acquiring history gathering and interview skills. Jurisdictional variations in legislation, policy, and standards, as well as overlapping agency/department regulations introduced practice variance. The validity and utility of EMS clinician-collected surveillance data were unclear.</p><p><strong>Conclusions: </strong>While EMS clinicians were recognized as a poorly understood, under-utilized, and under-equipped resource for IPV survivors, current literature is insufficient to comprehensively guide practice. Heterogeneity and limited quantity contribute to this challenge. Future research should leverage newly developed and validated measures to identify gaps responsive to educational and/or policy interventions and explore novel technologies to improve the quality of EMS clinician-collected IPV data. Equipping EMS clinicians with the tools to provide high-quality IPV care will benefit IPV survivors, EMS clinicians, and health care more broadly.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-35"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing Prehospital Care that is Optimized for Older Adult Patients: A Critical Opportunity to Reduce Harm.","authors":"William Haussner, Emily Benton, Rana Barghout, Joshua Lachs, David W Hancock, William Toon, Tony Rosen","doi":"10.1080/10903127.2025.2563875","DOIUrl":"https://doi.org/10.1080/10903127.2025.2563875","url":null,"abstract":"<p><p>Older adults represent a large and increasing fraction of 9-1-1 calls requiring emergency medical services (EMS) response. This population differs substantially from younger adults due to physiologic changes, cognitive impairment and behavioral disturbance, atypical presentation of disease, frailty, functional limitations, the impact of comorbid conditions, and the effects of polypharmacy. Not considering these when providing prehospital care is common and may lead to substantial harm for older adult patients. We therefore, recommend that EMS professionals consider system changes in education, protocol development, and quality improvement to improve care. Research gaps in optimal geriatric prehospital care should be identified and closed. The movement to improve care for older adults in emergency departments offers a model for how to effectively do so in the prehospital setting.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Pediatric Prehospital Destination Decision Support Tool (PDTree) on Emergency Medical Services Transport Patterns and Destination Choice.","authors":"Kyle A Fratta, Kevin Psoter, Taylor Craig, Jennifer N Fishe, Jennifer F Anders","doi":"10.1080/10903127.2025.2551172","DOIUrl":"10.1080/10903127.2025.2551172","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to compare emergency medical services (EMS) agency transport patterns for pediatric transports, including bypass of the nearest emergency department, before and after implementation of an evidence-based decision support tool to guide EMS clinicians' pediatric transport destinations.</p><p><strong>Methods: </strong>This is an observational cohort study comparing pediatric transports one year before and one year after implementation of the Pediatric Decision Tree (PDTree) tool in three geographically and demographically distinct fire-based EMS systems in Maryland, USA. Patients aged 0 to 17 years undergoing EMS transport from one of the three participating counties were included. Patients meeting trauma center transport criteria were excluded. Hospital pediatric capabilities were defined a priori, and geocoded scene and transport destination locations were used to determine bypass rates. Bypass patterns and distances were compared between the pre-implementation and post-implementation periods.</p><p><strong>Results: </strong>Included pediatric patients transported from the three counties numbered 9,782 in 2019 (post-implementation) and 11,945 in 2016 (pre-implementation). After implementation of the PDTree, 48.8% of all pediatric patients underwent EMS bypass of the nearest facility compared to 42.6% before implementation (p < 0.001). While the overall rate of bypass increased, the bypass proportion transporting to the highest-level pediatric facility decreased from 63.1% to 50.1% and the proportion of bypass to intermediate pediatric facilities increased from 26.2% to 37.7% (p < 0.001).</p><p><strong>Conclusions: </strong>Implementation of the PDTree pediatric direct transport decision support tool increased the bypass rate and, subsequently, direct transport to more pediatric capable facilities. Despite this increase in the bypass of the nearest facility, the proportion transporting to large tertiary specialty children's centers decreased, while there was a significant increase in transport to intermediate pediatric facilities. Regional and national EMS governing bodies should balance benefits of pediatric direct transport protocols with operational costs to better meet the needs of pediatric populations.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Emergency Medical Services Medical Director and Natural Disasters: The Sarasota, Florida Experience During Hurricane Milton.","authors":"George M Nackley, David M Langley, Marshall A Frank, Pia Daniel, O J Ma","doi":"10.1080/10903127.2025.2551893","DOIUrl":"10.1080/10903127.2025.2551893","url":null,"abstract":"<p><p>The state of Florida prepares for hurricanes annually, particularly from late summer to fall. These hurricanes put immense pressure on public services, especially emergency medical services (EMS). This paper highlights the critical role of the EMS medical director in Sarasota, Florida, within the community during disaster response. It outlines the medical director's responsibilities, situations, protocols, and limitations encountered during Hurricane Milton. Specifically, this paper will illustrate a series of cases and their responses during periods of severe winds, which forced 9-1-1 services, including ambulance and fire, to remain at their stations due to dangerous weather. On October 9th, 2024, Hurricane Milton made landfall in southwest Florida around 20:30. It struck the barrier island of Siesta Key in Sarasota County, which spans 550 square miles and has a population of 469,013. The county reported winds exceeding 120 miles per hour. In the wake of Hurricane Milton's landfall, a record 47 tornadoes simultaneously appeared across the state, leading to widespread destruction. Milton is associated with at least 24 fatalities in Florida, with seven deaths directly linked to the tornadoes. This paper reviews the highest acuity cases and the medical director's role in them, including incidents of carbon monoxide poisoning, a power generator explosion resulting in severe burns, pediatric cardiac arrest, uncontrolled hemorrhage, and hypoxia in individuals dependent on oxygen due to a power outage. The authors recognize that protocols may differ from state to state. However, the goal here is to compile relevant cases to present to the EMS community to better understand the events that transpired, aimed at improving future disaster response when hazardous weather restricts standard on-scene EMS operations. The Sarasota County EMS system believes that out-of-hospital patients are under the care of the EMS medical director until they reach an emergency department. The aim is to clarify the medical director's specific roles by analyzing several cases and their outcomes, where known, and the lessons learned by the medical director, Sarasota County Dispatch, and Sarasota County EMS during periods of inactivity caused by heavy winds accompanied by several recommendations based on these experiences.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fenestrated Catheters are Superior to Non-Fenestrated Needle Thoracostomy Catheters in a Cadaveric Tension Pneumothorax Model.","authors":"Adam J Kruse, Jennifer Achay, Emily Epley, Jeffrey Swenson, Brian Ferguson, Jeffrey E Rollman, Erik DeSoucy, Shannon N Thompson, David Wampler","doi":"10.1080/10903127.2025.2549726","DOIUrl":"10.1080/10903127.2025.2549726","url":null,"abstract":"<p><strong>Objectives: </strong>Tension pneumothorax (tPTX) is the third leading cause of preventable death on the battlefield. Needle thoracostomy (NT) is the standard prehospital treatment; however, the optimal catheter characteristics are unknown. This study compares the efficacy of NT using 3.25-inch 14ga and 3.25-inch 10ga, non-fenestrated and fenestrated catheters in a tPTX model.</p><p><strong>Methods: </strong>This was a non-randomized, non-blinded study using fresh, unembalmed, never frozen, human cadavers. Tension pneumothorax was induced by air insufflation to 15 mmHg through a 10ga pleural catheter. The tPTX was then released through the test devices (14ga non-fenestrated, 14ga fenestrated, 10ga non-fenestrated, 10ga fenestrated) placed at either the 5th intercostal space (ICS) anterior-axillary line or 2nd ICS mid-clavicular line. The change in intrathoracic pressure and the time to lowest pressure were recorded. The primary end point was the successful relief of tPTX which was defined as a decrease in pleural pressure to <4 mmHg. The needle thoracostomy catheter was capped, tPTX was reestablished, and the process was repeated for the remaining three locations.</p><p><strong>Results: </strong>The protocol was performed on twelve cadavers with two NT procedures performed on each side of the chest. Non-fenestrated catheters were successful in 7/16 (44%) attempts while fenestrated catheters were successful in 27/32 (84%) attempts, <i>p</i> < 0.01. Median time to minimum pressure was 33.0 s (IQR 19.1, 46.3) seconds for non-fenestrated and 30.9 s (IQR 19.8, 37.8) seconds for fenestrated catheters, <i>p</i> = 0.96. The median time to minimum pressure was 36.0 s (IQR 26.1, 44.8) for 14ga catheters and 21.2 s (IQR 10.9, 35.5) for 10ga catheters, <i>p</i> = 0.01.</p><p><strong>Conclusions: </strong>Fenestrated NT catheters were superior to non-fenestrated catheters in the management of tPTX in this cadaver model. There is reasonable expectation of similar performance in real-world use. The selection of 14ga versus 10ga catheters is less important than inclusion of fenestrations for rapid relief of tension physiology.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Leave and Lactation Policy for EMS Clinicians - A Position Statement and Resource Document of NAEMSP.","authors":"Amelia M Breyre, Kari B Haley, Ingrid Bloom, Catherine R Counts, Tiffany Abramson, Shira A Schlesinger, Katherine Couturier, Angela Wright, Zita Konik, Grace Engel, Carson Cotrino, Mary P Mercer","doi":"10.1080/10903127.2025.2537244","DOIUrl":"10.1080/10903127.2025.2537244","url":null,"abstract":"<p><p>The National Association of EMS Physicians (NAEMSP) and the National Association of Emergency Medical Technicians (NAEMT) believe in an evidence-based and pragmatic approach to promoting a healthy emergency medical services (EMS) workforce and work environment. All EMS clinicians have the right to grow and care for families, should they choose.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agency-Level Factors Associated with EMS Volume for High-Impact Clinical Conditions and Patient Populations.","authors":"Sriram Ramgopal, Rebecca E Cash, Christian Martin-Gill","doi":"10.1080/10903127.2025.2550598","DOIUrl":"10.1080/10903127.2025.2550598","url":null,"abstract":"<p><strong>Background: </strong>Emergency medical services (EMS) agencies play a crucial role in delivering prehospital care, yet significant variability exists in EMS call volume and the conditions encountered. Variation in EMS call volume across agencies (i.e., high- vs. low-frequency) for specific patient populations and clinical presentations across EMS agencies can have substantial impact on implementation strategies for new guidelines and performance measures. We sought to evaluate agency-level factors associated with EMS volume of specific clinical presentations to inform the planning of targeted quality improvement efforts and resource allocation related to specific high-impact clinical categories.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the 2022 and 2023 National EMS Information System datasets, identifying EMS agencies that consistently reported patient encounters over a two-year period. We categorized encounters by key patient populations and clinical presentations, including cardiac arrest, trauma, stroke, pediatric cases, advanced airway management, and non-transport disposition. We used negative binomial regression to assess factors associated with EMS volumes.</p><p><strong>Results: </strong>We included 7,230 EMS agencies, with 55,705,469 encounters. The median number of encounters by EMS agency was 1,988 encounters averaged per year (IQR 706-5,584 encounters averaged per year). Cardiac arrest was more frequent in mixed/volunteer agencies and less common in for-profit, non-hospital, and tribal-based EMS services. Trauma volume was higher in advanced life support (ALS) and critical care agencies, the West (relative to Midwest), and mixed/volunteer agencies (relative to non-volunteer agencies). Stroke volume was linked to greater ALS/critical care agencies and mixed/volunteer agencies but was lower in urban areas. Pediatric encounters were more common in urban, mixed/volunteer agencies, and tribal services but less frequent in for-profit and hospital-based agencies. Airway interventions were associated with ALS/critical care agencies, but were less frequent in tribal agencies. Non-transport occurred more commonly in ALS agencies and tribal agencies.</p><p><strong>Conclusions: </strong>Distinct patterns of agency-level characteristics appear to exist in relation to the volume of EMS responses for specific patient populations and clinical presentations. These findings can inform agency-specific strategic planning for guideline implementation, resource allocation, and quality improvement in prehospital care.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-Assisted Versus Audio-Assisted Dispatcher Cardiopulmonary Resuscitation for Optimizing Compression Quality in Simulated Scenarios: A Network Meta-Analysis of Randomized Controlled Trials.","authors":"Xinyu Tan, Xiaokai Wang, Xiangmin Li, Xinbo Yin","doi":"10.1080/10903127.2025.2547651","DOIUrl":"10.1080/10903127.2025.2547651","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate video-assisted dispatcher cardiopulmonary resuscitation (V-DACPR) versus audio-assisted dispatcher CPR impacts on compression quality in simulated out-of-hospital cardiac arrest (OHCA) scenarios.</p><p><strong>Methods: </strong>Network meta-analysis of randomized controlled trials (RCTs) compared V-DACPR versus audio-assisted dispatcher CPR (A-DACPR) and control. The primary outcome was the compression rate; the secondary outcomes included compression depth, time to first compression, and interruption time. Network meta-analysis of RCTs compared dispatcher-guided CPR with video feedback versus telephone-only instructions in simulated OHCA scenarios using high-fidelity manikins. Three intervention arms were compared: video-assisted CPR, audio-assisted CPR, and unguided CPR (control). Standardized mean differences (SMD) and surface under the cumulative ranking curve (SUCRA) were calculated using Bayesian network meta-analysis methodology.</p><p><strong>Results: </strong>Fifteen trials (<i>n</i> = 1,556) were analyzed. V-DACPR showed superior compression rates versus A-DACPR (impact size: -21.37, 95% CI: -36.10, -7.41) and control (-43.04, 95% CI: -63.05, -22.52). V-DACPR demonstrated better time to first compression versus control (-42.23, 95% CI: -83.31, -1.42) and favorable trends in compression depth (-5.06, 95% CI: -12.40 to 2.12) and interruption time, though several comparisons between V-DACPR and A-DACPR did not reach statistical significance. Heterogeneity was low to moderate (I² = 12-63%). Confidence in network meta-analysis (CINeMA) assessment supported moderate to high-quality evidence.</p><p><strong>Conclusions: </strong>V-DACPR demonstrated significant advantages in compression rate in simulated scenarios, with favorable trends in other quality metrics compared to A-DACPR. These findings support the potential for video assistance technology in dispatcher-guided CPR, particularly for optimizing compression rates. However, these results were observed in simulation studies and require validation in real-world clinical settings to determine their impact on patient outcomes.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Real-Time Feedback Devices on Paramedic Bag-Valve-Mask Ventilation Performance.","authors":"Julian Lasik, Tomasz Kłosiewicz, Mateusz Puślecki","doi":"10.1080/10903127.2025.2552354","DOIUrl":"10.1080/10903127.2025.2552354","url":null,"abstract":"<p><strong>Objectives: </strong>Ventilation using a self-expanding bag and face mask poses important challenges, even for experienced healthcare professionals. Several devices have been developed and introduced to the market with the aim of improving the quality of bag-valve-mask (BVM) ventilation. The objective of this study was to evaluate whether the use of a real-time ventilation feedback device (VFD) influences ventilation quality.</p><p><strong>Methods: </strong>This study recruited one hundred paramedics to perform manual ventilation on a high-fidelity manikin using a BVM, first without and subsequently with the VFD. Participants received a brief instruction on the use of VFDs. Each ventilation session lasted four minutes and was performed twice under both conditions. Ventilation parameters, including tidal volume and ventilation rate, were recorded using the SimMan manikin and LLEAP software.</p><p><strong>Results: </strong>Significant differences in ventilation parameters were observed between the two conditions. Ventilation without the VFD was associated with a higher mean tidal volume (390.1 mL vs. 373.9 mL, <i>p</i> < 0.001) and a higher mean ventilation rate (8.9 breaths per minute [bpm] vs. 8.1 bpm, <i>p</i> < 0.001). Minute ventilation was also significantly greater without the VFD (3504.0 mL vs. 3118.8 mL, <i>p</i> < 0.001). Despite these differences, the use of the VFD led to a slight improvement in compliance with European Resuscitation Council (ERC) ventilation guidelines, increasing the rate of correct ventilations from 1% to 3%.</p><p><strong>Conclusions: </strong>While the use of the VFD was associated with reductions in tidal volume and ventilation rate, it resulted in a modest improvement in adherence to ERC ventilation guidelines. The clinical impact of this device remains unclear. Future studies can focus on novel/innovative ways to enhance compliance with established ventilatory parameters.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}