Prehospital Emergency Care最新文献

{"title":"Opportunities for Physical Activity Behavior Change Among Emergency Medical Services Clinicians: Qualitative Investigation.","authors":"Michael W Supples, Allison M Chandler, Jason T Fanning, Anna C Snavely, Nicklaus P Ashburn, Stephen L Powell, James E Winslow, Jason P Stopyra, Justin B Moore, Simon A Mahler","doi":"10.1080/10903127.2025.2479124","DOIUrl":"10.1080/10903127.2025.2479124","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency medical services (EMS) clinicians often do not achieve sufficient levels of physical activity. We investigate behavioral determinants that influence participation in physical activity among EMS clinicians.</p><p><strong>Methods: </strong>We enrolled EMS clinicians from a North Carolina third-service EMS agency in 2023. A trained qualitative investigator conducted twenty virtual, 30-minute, individual, semi-structured interviews using an interview guide developed by experts in physical activity behaviors, EMS, and qualitative research. Interviews were guided by the Theoretical Domains Framework and Capability Opportunity Motivation Behavior Change Model. Structured interviews were digitally recorded and transcribed verbatim by a professional transcription service. Transcriptions were verified against audio for accuracy and de-identified. A codebook was established using a hybrid inductive/deductive approach, and thematic analysis was performed.</p><p><strong>Results: </strong>The 20 participants had a median age of 31 years (IQR 27-34), of which 65% (13/20) were female. Several key themes emerged that represent opportunities for behavioral intervention. First, physical activity is often viewed as a process requiring high inhibitory self-regulation and is often paired with highly restrictive behaviors, which likely leads to existing poor behavioral habits. Existing confidence in being physically active was often tied to goal setting and mastery experiences, suggesting an opportunity to leverage specific and achievable goal setting, self-monitoring, and feedback. Further, EMS clinicians often struggle with incorporating physical activity amid work and life demands in a practical, sustainable way. They also identified a lack of available time, resources, and organizational support. High-quality social networks are foundational behavior change components and were often lacking among participants.</p><p><strong>Conclusions: </strong>Behavioral determinants of physical inactivity included a theme of negative implicit associations around physical activity among some participants and need for achievable goal setting, self-monitoring, and building positive social support networks. Further investigation is needed to develop and test toolsets to improve physical activity behaviors among EMS clinicians.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625664","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":"Effectiveness of Prehospital Critical Care Scene Response for Major Trauma: A Systematic Review.","authors":"Jeremy Penn, Ryan McAleer, Carolyn Ziegler, Sheldon Cheskes, Brodie Nolan, Johannes von Vopelius-Feldt","doi":"10.1080/10903127.2025.2483978","DOIUrl":"10.1080/10903127.2025.2483978","url":null,"abstract":"<p><strong>Objectives: </strong>Major trauma is a leading cause of morbidity and mortality worldwide. It is unclear if the addition of a critical care response unit (CCRU) with capabilities comparable to hospital emergency departments might improve outcomes following major trauma, when added to Basic or Advanced Life Support (BLS/ALS) prehospital care. This systematic review describes the evidence for a CCRU scene response model for major trauma.</p><p><strong>Methods: </strong>We searched Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Ovid), CINAHL (EBSCOhost), Science Citation Index Expanded (Web of Science), Conference Proceedings Citation Index - Science (Web of Science), LILACS (Latin American and Caribbean Health Sciences Literature) for relevant publications from 2003 to 2024. We included any study that compared CCRU and BLS/ALS care at the scene of major trauma, reported patient-focused outcomes, and utilized statistical methods to reduce bias and confounding. The risk of bias was assessed by two independent reviewers, using the ROBINS-I tool. Based on our a priori knowledge of the literature, a narrative analysis was chosen. The review was prospectively registered (PROSPERO ID CRD42023490668).</p><p><strong>Results: </strong>The search yielded 5243 unique records, of which 26 retrospective cohort studies and one randomized controlled trial met inclusion criteria. Sample sizes ranged from 308 to 153,729 patients. Eighteen of the 27 included studies showed associations between CCRUs and improved survival following trauma, which appear to be more consistently found in more critically injured and adult patients, as well as those suffering traumatic cardiac arrest. The remaining nine studies showed no significant difference in outcomes between CCRU and BLS/ALS care. Most studies demonstrated critical or severe risks of bias.</p><p><strong>Conclusions: </strong>Current evidence examining CCRU scene response for major trauma suggests potential benefits in severely injury patients but is limited by overall low quality. Further high-quality research is required to confirm the benefits from CCRU scene response for major trauma.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701322","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 Spector Job Satisfaction Survey: Associations of Satisfaction with Leaving EMS.","authors":"Christopher B Gage, Lakeshia Logan, Jacob C Kamholz, Jonathan R Powell, Shea L van den Bergh, Eben Kenah, Ashish R Panchal","doi":"10.1080/10903127.2025.2482100","DOIUrl":"10.1080/10903127.2025.2482100","url":null,"abstract":"<p><strong>Objectives: </strong>Detailed job satisfaction evaluations are often used to build strategies for employee retention. Despite recognizing that emergency medical services (EMS) dissatisfaction drives turnover, validated tools rigorously evaluating satisfaction have not been employed. We aim to assess the association between EMS clinician satisfaction and their likelihood of leaving the profession using the validated Spector Job Satisfaction Survey (JSS).</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of nationally certified EMS clinicians in the United States recertifying between October 2022 and April 2023. Our primary outcome was the self-reported likelihood of leaving EMS within 12 months (likely or not likely to leave). The primary exposure was job satisfaction, assessed using the 36-item JSS, scored from 36 to 216, and analyzed in two models: total satisfaction (dissatisfied [scores 36-108], ambivalent [108-144], satisfied [144-216]), and satisfaction subscales (e.g., pay, promotion, supervision). We applied Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify key predictors of intent to leave EMS, adjusting for demographic and agency characteristics. Post-LASSO Bayesian logistic regression estimated odds ratios (OR) and 95% credible intervals (CrI).</p><p><strong>Results: </strong>Among 33,414 EMS clinicians (response rate: 26.3%), the median age was 36 years (IQR: 29,46), 74.2% were male, and 83.0% were White, non-Hispanic. Most respondents worked full-time (77.6%), primarily as EMTs (48.5%), in urban settings (89.9%). Mean satisfaction scores were higher among those not likely to leave EMS (146.7 [standard deviation: 29.0]) than those likely to leave (121.2 [28.4]). Odds of leaving decreased for more satisfied clinicians: ambivalent clinicians [0.35 (0.32-0.38)]; satisfied clinicians [0.11 (0.10-0.13)]; referent dissatisfied. Additionally, specific satisfaction subscales were associated with lower odds of leaving for those satisfied compared to those dissatisfied, including nature of work [0.32 (0.28-0.37)], pay [0.46 (0.40-0.52)], promotion opportunities [0.53 (0.47-0.61)], supervision [0.65 (0.57-0.73)] and contingent rewards [0.77 (0.67-0.88)].</p><p><strong>Conclusions: </strong>The EMS clinicians with higher satisfaction with their nature of work, pay, and promotion opportunities were less likely to report intent to leave. These findings highlight key factors that may inform workforce retention efforts.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664311","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":"Improving Bystander Response: How Long Does It Take to Retrieve an AED From Varying Distances.","authors":"Erin R Gramm, Jorge A Gumucio, Kate Flickinger, David D Salcido, James J Menegazzi","doi":"10.1080/10903127.2025.2475323","DOIUrl":"10.1080/10903127.2025.2475323","url":null,"abstract":"<p><strong>Objectives: </strong>Survival from out-of-hospital cardiac arrest (OHCA) is low, with less than 10% surviving to hospital discharge. Early defibrillation can improve survival from an OHCA with a shockable rhythm. Cell phone applications alert rescuers as to where victims are and where automated external defibrillators (AEDs) are located, but guidance on choosing between going to the victim and doing cardiopulmonary resuscitation and retrieving an AED is lacking. We sought to determine the time required to retrieve AEDs at varying distances in a real-life setting. At a distance greater than 400 meters away, that AED retrieval time will be longer than median emergency medical services (EMS) first response time of 6.9 min, based on national data from the Cardiac Arrest Registry to Enhance Survival (CARES) registry.</p><p><strong>Methods: </strong>Thirty study participants (15 male, 15 female) performed four AED retrieval runs, separated by at least 24 h. Three runs simulated a real-life OHCA situation outdoors on a busy street in our city (in all four seasons), and one was unimpeded on an indoor track. The AED retrieval distances were 200 meters (400 roundtrip), 400 meters (800 roundtrip), and 600 meters (1,200 roundtrip) The middle distance (400/800 meters) was chosen for the track run.</p><p><strong>Results: </strong>The mean run times were 4.05 min for the 200/400 m retrieval, 6.62 min for the 400/800 m, 8.62 min for the 600/1,200 m, and 4.35 min for the 400/800 m track run, which is 2.3 min shorter than the 400/800 m real-life run and significantly different (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Barriers to mobility, like traffic lights, motor vehicles, weather conditions, and pedestrians, have significant impacts on how long it takes for an AED to be retrieved and returned to the patient's side. Using these simulation runs, we demonstrated that short AED retrieval distances are likely necessary to impact survival. When compared to our national EMS first response times, only the 200/400 m retrieval distance would likely provide sufficient time for a responder to retrieve, arrive at the patient's side and utilize an AED prior to EMS arrival.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-5"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692967","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":"Prehospital Trauma Compendium: Transfusion of Blood Products in Trauma - A Position Statement and Resource Document of NAEMSP.","authors":"Joshua B Brown, Mark H Yazer, Joseph Kelly, Philip C Spinella, Valerie DeMaio, Andrew D Fisher, Andrew P Cap, C J Winckler, Gerald Beltran, Christian Martin-Gill, Francis X Guyette","doi":"10.1080/10903127.2025.2476195","DOIUrl":"10.1080/10903127.2025.2476195","url":null,"abstract":"<p><p>Hemorrhagic shock remains the leading cause of potentially preventable death among injured patients with life-threatening bleeding. Prehospital resuscitation has been evolving with increasing use of blood product resuscitation. The impact of blood administration on patient outcomes remains poorly defined with significant heterogeneity in the quality of literature supporting prehospital blood product resuscitation after trauma. We completed a structured search of the literature using a rapid review framework based on three distinct PICO questions to develop systematic and consensus recommendations.</p><p><p>The National Association of Emergency Medical Services Physicians (NAEMSP) recommends, in EMS agencies/systems that can support a high-quality prehospital blood transfusion program:Use of blood components over crystalloids for the first-line treatment of patients with traumatic life-threatening bleeding in the prehospital phase of resuscitationUse of low titer group O whole blood (LTOWB) as the first-choice blood product for treatment of patients with traumatic life-threatening bleeding in the prehospital phase of resuscitationUse of a combination or composite of prehospital transfusion indications, focused on physiologic abnormalities and/or injury patterns with obvious significant blood loss.Use of active monitoring for transfusion-related adverse events.Developing a mechanism to recycle unused blood product units nearing their expiration date to a high-use hospital facility to minimize wastage.Engaging in a comprehensive longitudinal active collaboration between EMS agencies, trauma centers, and blood suppliers to ensure the success of a prehospital transfusion program.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701327","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":"Emergency Medical Services (EMS) Clinician Perspectives on the Pediatric Observation Priority Score (POPS).","authors":"Caleb E Ward, Daniel X Zhang, Judith Singletary, Damian Roland, James M Chamberlain","doi":"10.1080/10903127.2025.2477213","DOIUrl":"10.1080/10903127.2025.2477213","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately 50% of children assessed by emergency medical services (EMS) in the United States (U.S.) have no emergent needs. The lack of validated triage tools to identify children at low risk of deterioration without transport is one reason that children have not been included in most alternative disposition programs. The Pediatric Observation Priority Score (POPS) is a triage tool incorporating vital signs and clinical observations. British prehospital studies show the POPS accurately identifies low-acuity children. The POPS has not been assessed in the U.S. Our objective was to determine whether U.S. EMS clinicians find the POPS acceptable, appropriate, and feasible.</p><p><strong>Methods: </strong>We conducted a mixed methods study with EMS clinicians. Participants were provided with an overview of the POPS then completed a survey using the validated Acceptability, Appropriateness, and Feasibility of Implementation Measures (12 Likert-scale questions [1 = strongly disagree to 5 = strongly agree]). We calculated mean question scores. A PhD-trained facilitator conducted cognitive interviews with a subset of participants to explore their perception of the POPS. Multiple investigators coded transcripts until we reached thematic saturation.</p><p><strong>Results: </strong>We recruited 100 participants (51% paramedics, 48% emergency medical technician (EMTs)) with a median (IQR) of 5 years (3, 9) clinical experience. Individual question mean scores across all domains ranged from 4.4-4.6. Paramedic and EMT responses were similar. 10 participants completed interviews and agreed the POPS was acceptable, appropriate, and feasible. Positive themes from analysis included: (1) ease of use and (2) helpful additional tool. Facilitators to implementation included (1) embedding the POPS in documentation systems (2) with a force function, (3) positive messaging, and (4) incorporating the POPS in protocols. Implementation barriers included (1) resistance to mandatory documentation, (2) undermining professional standing, (3) impaired rapport with patients, (4) uncertainty about integration with protocols, (5) and concern about legal liability. Participants suggested changes in wording and question order to improve usability.</p><p><strong>Conclusions: </strong>Prehospital clinicians in the U.S. find the POPS acceptable, appropriate, and feasible for implementation with minor modifications. Further research is needed to determine whether EMS clinicians can accurately apply the POPS in controlled and field settings before implementation.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575818","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":"Disparities of Aspirin Administration for Prehospital Chest Pain and ST Elevation Myocardial Infarctions.","authors":"Anna Maria Johnson, Hei Kit Chan, Renee Johnson, Anastasia S Papin, Daniel C Walter, N Clay Mann, Benjamin Fisher, Larissa Myaskovsky, Ryan M Huebinger","doi":"10.1080/10903127.2025.2473684","DOIUrl":"10.1080/10903127.2025.2473684","url":null,"abstract":"<p><strong>Objectives: </strong>Although disparities exist in aspirin administration for chest pain and ST elevation myocardial infarctions (STEMI), little is known about community-based disparities in aspirin administration for prehospital patients. We evaluated disparities in prehospital aspirin using a national prehospital database.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the 2018-2021 NEMSIS database linked to census data, including adult prehospital encounters. We created two cohorts: dispatch reason of chest pain and identified STEMI on prehospital EKG. We stratified patients based on majority ZIP Code race/ethnicity (>50% White, Black, and Hispanic) and into quartiles based on household income. Using multivariable logistic regression, we evaluated the association between incident community characteristics and aspirin administration.</p><p><strong>Results: </strong>We included 4,881,663 chest pain encounters and 184,610 STEMIs. Chest pain encounters in majority White communities (32.3%) received aspirin more often for chest pain than Black (22.1%; aOR 0.59, [0.59-0.60]) or Hispanic (24.8%; aOR 0.66, [0.66-0.67]) communities. Compared to the top income quartile (29.0%), the lowest income quartile had lower odds of aspirin administration (4th-27.6%; aOR 0.93, [0.92-0.94]). For STEMIs, adjusted odds of aspirin administration were higher for White (53.4%) than Black (52.5%; aOR 0.81, [0.78-0.84]) or Hispanic (53.6%; aOR 0.93, [0.89-0.96]) patients. Compared to the highest income quartile (55.0%), lower quartiles had lower odds of aspirin administration (2nd-54.2%; aOR 0.95, [0.92-0.97]; 3rd-52.9%; aOR 0.93, [0.91-0.96]; 4th-52.0%; aOR 0.86, [0.84-0.89]).</p><p><strong>Conclusions: </strong>Patients from Black, Hispanic/Latino, and lowest-income communities received aspirin for chest pain at a lower rate than white or high-income patients.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557792","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":"Prehospital Blood Lactate Measurements in Ambulances and Associations with Outcomes: A Cohort Study.","authors":"Louise H Walther, Erika F Christensen, Annmarie T Lassen, Christian B Mogensen, Søren Mikkelsen","doi":"10.1080/10903127.2025.2473034","DOIUrl":"10.1080/10903127.2025.2473034","url":null,"abstract":"<p><strong>Objectives: </strong>The prehospital use of blood lactate measurements is increasing. The blood lactate level is a well-recognized biomarker of poor outcomes, mainly investigated in potentially critically ill patients or patients with specific illnesses. However, evidence of a correlation in a broad prehospital setting with undifferentiated patients is lacking. This study aimed to investigate the correlation between prehospital blood lactate levels and the risks of poor outcomes in undifferentiated prehospital patients with apparent non-life-threatening conditions.</p><p><strong>Methods: </strong>This was a large cohort study of undifferentiated prehospital patients aged ≥18 years old who required intravascular accesses during prehospital care from February 3 to June 14, 2020. StatStrip Xpress Lactate Meter analyzed the lactate levels. The primary outcome was the risk of 7-day mortality. Follow-up was 90 days. The categorical secondary outcomes were 30-day and 90-day mortality risks and risks of mechanical ventilation, vasopressor treatment, or acute renal replacement therapy. Other secondary outcomes were the number of days alive within 30 days outside the hospital, outside the intensive care unit, and without mechanical ventilation. The primary analyses were uni- and multivariate logistic regressions presented as odds ratios (OR) with 95% confidence intervals (CI) and p-values.</p><p><strong>Results: </strong>The study included 11,515 patients. The overall 7-day mortality rate was 3.1%. The 7-day mortality rates were 2.0%, 3.6%, and 12.8% in patients with lactate levels of <2.0 mmol/L, 2.0-3.9 mmol/L and ≥4.0 mmol/L, respectively. The risk of 7-day mortality increased with elevated lactate level, OR = 1.43 (95% CI: 1.36-1.51), <i>p</i> < 0.001. The ORs were similar in all prespecified diagnostic subgroups except for patients receiving diagnoses within the nervous system. Patients with elevated lactate levels had increased risks of all categorical secondary outcomes. They stayed longer in the hospital, in the intensive care unit, and on mechanical ventilation than the patients with normal prehospital lactate levels.</p><p><strong>Conclusions: </strong>: This study found evidence of correlations between elevated lactate levels and poor outcomes in all acute prehospital patients except patients receiving diagnoses within the nervous system. Implementing prehospital lactate measurements is useful if knowledge of the patient's lactate levels adds to existing parameters in the prehospital setting.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557795","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":"Creation of a Novel National Dataset Through Linkage of Emergency Medical Services (EMS) Transport Destination and Verified Emergency Department (ED) Capability.","authors":"Rebecca E Cash, Remle P Crowe, Maeve Swanton, Krislyn M Boggs, Scott A Goldberg, Ashley F Sullivan, Carlos A Camargo, Kori S Zachrison","doi":"10.1080/10903127.2025.2470286","DOIUrl":"10.1080/10903127.2025.2470286","url":null,"abstract":"<p><strong>Objective: </strong>Emergency department (ED) capabilities, such as trauma center or stroke center designation, are key to understanding the effects of emergency medical services (EMS) transport destination decisions on patient outcomes. In current EMS datasets, ED capabilities are self-reported by the EMS clinician or agency. The reliability and validity of the EMS-reported ED capabilities is unknown. Our objective was to link EMS transport destinations with verified ED capability data to develop a novel national dataset to better understand prehospital routing practices.</p><p><strong>Methods: </strong>We linked two cross-sectional databases: the 2021 ESO Data Collaborative and the 2021 National Emergency Department Inventory (NEDI)-USA. The ESO Data Collaborative contains de-identified prehospital patient care records from nearly 2,000 participating EMS agencies across the United States. The NEDI-USA is a survey of all nonfederal, non-specialty U.S. EDs open 24/7/365 (including freestanding EDs), with verified stroke, trauma, and burn capability data. From EMS records, we obtained all unique destinations designated as \"hospital\" as of 2021. After verifying addresses were NEDI-eligible EDs (i.e., providing emergency services 24/7/365), we performed a 3-step linkage process to NEDI-USA: (1) name/address exact matches; (2) probabilistic matching on name/address based on bigrams, accepting adequate (>85%) match scores after review; and (3) hand-matching using Google Maps. We calculated descriptive statistics to describe the linkage process.</p><p><strong>Results: </strong>Of the 9,420 unique \"hospital\" destinations in the EMS dataset, 2,714 (29%) were non-hospital facilities (e.g., nursing home) or were non-NEDI-eligible (e.g., specialty hospital such as a psychiatric facility). We linked 98% (<i>n</i> = 6,605/6,706) of NEDI-eligible EMS hospital transport destinations to EDs in NEDI-USA. Excluding duplicate addresses for a single hospital (e.g., ED address versus main entrance address), the linked addresses represented 3,877 unique EDs in 49 states, which included 68% (<i>n</i> = 3,821/5,580) of the EDs included in the 2021 NEDI-USA database.</p><p><strong>Conclusions: </strong>We successfully linked 98% of EMS ED transport destinations to verified ED capability information. This novel linked dataset now includes rich destination capability information associated with each EMS transport that can be leveraged for describing and improving routing practices for specific patient conditions, such as patients with stroke-like symptoms to stroke centers or major traumas to verified trauma centers.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468777","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":"Prehospital Trauma Compendium: Management of Injured Pregnant Patients- A Position Statement and Resource Document of NAEMSP.","authors":"Lauren M Maloney, Ashley N Huff, Katherine Couturier, Karin A Fox, John W Lyng, Christian Martin-Gill, Rickquel P Tripp, Jenna M B White, Francis X Guyette","doi":"10.1080/10903127.2025.2473679","DOIUrl":"10.1080/10903127.2025.2473679","url":null,"abstract":"<p><p>The assessment and management of critically injured pregnant trauma patients represents a high-risk, low-frequency event. One in every 12 pregnant patients experience physical trauma during their pregnancy, but only 0.1% experience major trauma with an injury severity score (ISS) greater than fifteen. It is crucial that emergency medical services (EMS) clinicians understand the anatomic and pathophysiologic changes that impact morbidity and mortality for pregnant trauma patients so they can effectively provide life-saving interventions and resuscitation for this patient population.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557797","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}