Prehospital Emergency Care最新文献

{"title":"Large Language Models Exhibit High Performance as Computable Phenotypes for Pediatric Asthma Exacerbation Detection in a Retrospective, Observational Study of Emergency Medical Services Encounters.","authors":"Ira Harmon, Isabel Sanchez-Cano, Jennifer Brailsford, Jennifer Fishe","doi":"10.1080/10903127.2026.2683523","DOIUrl":"10.1080/10903127.2026.2683523","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric asthma exacerbations are a common emergent condition treated by prehospital emergency medical services (EMS). However, retrospective identification of those patients for research, educational, and quality improvement purposes can be difficult given the unique structure of EMS' electronic health records. Computable phenotypes are algorithms used to identify patients of interest. The objective of this study was to explore the performance of large language models (LLMs) as pediatric asthma computable phenotypes for EMS data.</p><p><strong>Methods: </strong>This is a retrospective, observational study testing the performance of state-of-the-art, open-source, general-purpose LLMs (Gemma-2, Llama-3.1-8B, Llama-3.3-70B, and Mistral-0.3), and one LLM specifically designed for medical use (OpenBioLLM), as pediatric asthma exacerbation computable phenotypes for EMS data. The goal of the phenotype was a binary classification of yes or no for an EMS encounter for a pediatric asthma exacerbation. We examined EMS patient encounter data from the ESO Data Collaborative between January 1, 2018 and December 31, 2021 for patients ages 2-18 years. Two pediatric emergency medicine physicians independently reviewed and annotated 1,000 encounters to label patients as pediatric asthma exacerbations. We tested models on structured and/or unstructured data, and explored basic and chain-of-thought prompts. We measured model performance using specificity, sensitivity, positive predictive value, negative predictive value, and macro F1.</p><p><strong>Results: </strong>After applying the inclusion-exclusion criteria, 24,283 patient encounters remained. The median age was 12 years, with a slight majority (51%) of female patients. The best performing LLM overall was Llama 3.3's 70 billion parameter model using unstructured and structured data with 10-shot chain-of-thought prompts, with a F1 score of 0.894. Unstructured data alone gave the best F1 score for all models except Llama-3.3-70B and Mistral-0.3. Chain-of-thought prompts were more likely to produce better results than basic prompts, with 4 out of the 5 models giving their best performance when prompted by a chain-of-thought prompt.</p><p><strong>Conclusions: </strong>In this work we demonstrate that open source LLMs can be tailored for use as accurate prehospital pediatric asthma computable phenotypes using EMS data. To our knowledge, this represents the first LLM-based computable phenotypes trained on EMS data.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-15"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164068","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 Application of Pelvic Binders for Suspected Pelvic Ring Injuries: A Retrospective Cohort Study.","authors":"Lindsay Maclean, David Friedman, Anisa Nazir, Morgan Hillier, Melissa McGowan, Ian R Drennan, Brodie Nolan","doi":"10.1080/10903127.2026.2686790","DOIUrl":"10.1080/10903127.2026.2686790","url":null,"abstract":"<p><strong>Objectives: </strong>Pelvic fractures are linked to morbidity and mortality from major trauma. The use of pelvic binders in the prehospital setting is recommended for initial stabilization, however indications for application vary. The primary objective of this study was to determine the proportion of patients with image confirmed pelvic fracture in which paramedics applied a pelvic binder. Additionally, patient characteristics were explored to identify associations with unstable pelvic fractures.</p><p><strong>Methods: </strong>This was an observational retrospective cohort study from a single trauma center between January 2017 and December 2022. Patients were included if >16 years of age, transported from scene, and had a confirmed pelvic fracture on imaging. A manual review of electronic medical records and ambulance call records was performed by two reviewers. Continuous variables were summarized as means and standard deviations or medians and interquartile ranges. Categorical variables were summarized as counts and percentages. Multivariable logistic regression explored the association between predetermined prehospital predictors and unstable pelvic fracture. The results of the regression model are presented as odds ratios (OR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>In total, 429 patients met initial criteria; 95 were excluded for no records and 15 for no imaging, resulting in a final cohort of 319 patients. The median age was 42 (27-60) years, 61.1% were male, and 72.1% suffered blunt trauma. There were 86 (27.0%) fractures classified as unstable. Overall, 30 (9.4%) patients, 17% (14/86) with unstable fractures had a prehospital pelvic binder applied. Pain on exam and lower systolic blood pressure, and lower GCS score in the prehospital setting were all associated with increased odds of pelvic instability.</p><p><strong>Conclusions: </strong>Nine percent of all patients, and only 17% with an unstable pelvic fracture, had a pelvic binder applied in the prehospital setting. Several physical exam findings and vital signs were associated with unstable pelvic fracture; these could be helpful for increasing prehospital identification of pelvic fractures.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227284","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":"Trends and Regional Variation in Heat-Related EMS Encounters in the US.","authors":"M Chloe Slator, Margaret Greenwood-Ericksen, David P Sklar, Cameron Crandall, MingAn Yang, Tatsuya Norii, N Clay Mann, Benjamin Fisher, Ryan Huebinger","doi":"10.1080/10903127.2026.2687829","DOIUrl":"10.1080/10903127.2026.2687829","url":null,"abstract":"<p><strong>Objectives: </strong>Heat-related emergencies are increasing in the United States (U.S.), but little is known about trends in prehospital heat-related encounters. This study examines temporal and geographic trends in prehospital heat-related encounters and assesses demographic and clinical factors associated with these heat-related encounters.</p><p><strong>Methods: </strong>We used an observational study design and a retrospective analysis of the 2019-2023 National Emergency Medical Services Information System (NEMSIS) databases. We described the characteristics of heat-related encounters and compared the rates of heat-related complaints by year. Comparing 2019 to each year from 2020-2023, we used logistic regression to evaluate the odds of heat-related complaints. We then repeated these regressions for each U.S. census division to evaluate for regional variation in the trends of heat-related complaints.</p><p><strong>Results: </strong>We included 120,181,275 non-heat-related encounters and 478,666 heat-related encounters. Compared to non-heat-related encounters, heat-related encounters involved younger patients, more males, and higher rates of tachycardia and hypotension. The odds of heat-related encounters increased in 2023 compared to 2019 (odds ratio (OR) 1.04, (1.03-1.05)), but other years were similar. There was significant regional variation in heat-related encounters between Census Divisions, though. The largest increases were: 2020 - Mountain (OR 1.13 (1.09-1.16)); 2021 - Pacific (OR 1.25 (1.22-1.29)); 2022 - Mountain (OR 1.23 (1.19-1.26)) and West South Central (OR 1.19 (1.17-1.22)); 2023 - West South Central (OR 1.54 (1.51-1.57)) and West North Central (OR 1.18 (1.14-1.22)) and Mountain (OR 1.29 (1.25-1.33)).</p><p><strong>Conclusions: </strong>While national odds and proportions of heat-related prehospital encounters have risen slightly in 2023 compared to 2019, certain geographic regions have experienced far greater increases. Further research is needed to identify vulnerabilities and optimize emergency response strategies.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265834","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":"Description of the 2024 NEMSIS Public-Release Research Dataset.","authors":"Casey F Gregor, Amanda M Pope, Kevin Nicholes, Mengtao Dai, Rylee E Beckstead, Bengie Alexandre, N Clay Mann","doi":"10.1080/10903127.2026.2687827","DOIUrl":"10.1080/10903127.2026.2687827","url":null,"abstract":"<p><strong>Objectives: </strong>The National Emergency Medical Services Information System (NEMSIS) is a federally funded program that provides a standardized national framework for collecting and aggregating prehospital care data across the United States (U.S). The 2024 Public-Release Research Dataset is a recent compilation of emergency medical services (EMS) activations for evaluating public health surveillance, patient characteristics, and various EMS systems and patient care improvement initiatives.</p><p><strong>Methods: </strong>Using the 2024 NEMSIS Public-Release Research Dataset (NEMSIS Dataset), we analyze the dataset for completeness (i.e., presence of missing/null values), dataset content, and assess data generalizability. The analyses concentrate on 9-1-1 EMS responses that led to both treatment and transport of a patient, including all out-of-hospital cardiac arrest cases.</p><p><strong>Results: </strong>In 2024, 60,298,684 EMS activations were reported to the National EMS Database by 14,756 agencies serving 50 US states, D.C., and four territories. The majority of the 24.9 million 9-1-1 patient treated and transported activations were serviced by non-volunteer EMS services, mostly in urban areas. The most frequently reported patient complaints and impressions were for general medical concerns. Analysis of Ambulance Patient Offload Times (APOT) demonstrated expected variation by patient acuity.</p><p><strong>Conclusions: </strong>The 2024 National EMS Public-Release Research Dataset serves as an open-access tool for examining EMS usage patterns, response metrics, prehospital care practices, and patient outcomes. Though a near-complete census, users must account for its known limitations. Familiarity with the available documentation regarding NEMSIS version 3.5.0 will aid in addressing these limitations and the various metrics that are generated from the use of the 2024 NEMSIS Public-Release Dataset.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227280","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":"Pediatric Trauma Center Utilization for Children Transported by Emergency Medical Services.","authors":"Kendall J Donohue, Lois K Lee, Michael Monuteaux, Eric W Fleegler, Caitlin Farrell","doi":"10.1080/10903127.2026.2685690","DOIUrl":"10.1080/10903127.2026.2685690","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric trauma remains a leading cause of morbidity and mortality in the United States, and care at pediatric trauma centers (PTCs) is associated with improved outcomes. However, national patterns of emergency medical services (EMS) transport to PTCs for injured children meeting trauma center criteria are not well described. We sought to evaluate EMS transport patterns among injured children meeting American College of Surgeons (ACS) trauma center criteria and to identify factors associated with transport to a PTC.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the National EMS Information System (NEMSIS) public-release database from 2019 to 2022. We included patients younger than 16 years who were transported by EMS for injury and met ACS trauma center field triage criteria. Patient-level EMS data were linked with geographic information system (GIS) road network analyses of trauma center locations to assess geographic access to pediatric and general trauma centers. Geographic access was defined as being within a 60-minute ground transport interval to a trauma center. The primary outcome was EMS transport to a designated PTC among children meeting trauma criteria and with geographic access to a PTC. Secondary measures included patient demographics, injury characteristics, urbanicity, region, and EMS scene and transport intervals. Multivariable logistic regression was used to identify factors independently associated with transport to a PTC.</p><p><strong>Results: </strong>Of 793,459 injured children transported by EMS, 97,985 (12.3%) met trauma center criteria. Among those with access to a PTC (<i>n</i> = 54,923, 56%), only 40.6% were transported to one. Males and children with firearm injuries were more likely to reach a PTC, whereas adolescents, suburban, or rural patients were less likely. Median transport interval was 20 min for PTC transports versus 15 min for others.</p><p><strong>Conclusions: </strong>Despite meeting field triage criteria and having geographic access, less than half of injured children meeting trauma center criteria were transported to PTCs. Interventions to increase appropriate transport to PTCs and enhance pediatric readiness at non-PTCs are needed to optimize trauma care for children.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227367","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":"Effect of Compression Surfaces on Cardiopulmonary Resuscitation Quality and Clinician Fatigue.","authors":"Stephen Powell, Ashley Lutrick, Shriman Balasubramanian, Sharon Guarino, Lucas Boyer, Darrell Nelson, Michael W Supples","doi":"10.1080/10903127.2026.2676028","DOIUrl":"10.1080/10903127.2026.2676028","url":null,"abstract":"<p><strong>Objectives: </strong>Current American Heart Association (AHA) guidelines recommend moving patients to a hard surface, when possible, to improve cardiopulmonary resuscitation (CPR) quality. However, the time to move a patient detracts from the time actively performing CPR. Studies show mixed results on the effect of a soft surface on CPR quality. The primary objective of this study was to compare the fatiguability of performing CPR on the floor versus a standard mattress.</p><p><strong>Methods: </strong>This pilot randomized trial enrolled currently employed emergency medical services (EMS) clinicians from two EMS agencies in North Carolina from 10/2022 to 12/2022. Participants performed continuous compressions on a CPR manikin with integrated electronic feedback, randomized 1:1 to a floor or a mattress. The primary outcome was time to failure, defined as voluntary cessation of compressions by the participant or 30 s of inadequate compressions. Adequate compressions were defined using the current AHA recommendations for high-quality CPR, including a compression rate of 100-120/min and depth of at least 2 in. We describe time to failure and compression rate with median and interquartile range (IQR), and compare them between surfaces with the Wilcoxon Rank-Sum test. We constructed a survival curve of the time to failure by surface and compared them with a log-rank test.</p><p><strong>Results: </strong>Among 40 participants, 47.5% (19/40) were female and 90.0% (36/40) were White with an average age of 28 (IQR 24-33) years. The time to failure for floor CPR was 145 s (IQR 65-240) vs. 140 s (IQR 100-420) for mattress CPR (<i>p</i> = 0.64). Floor participants performed compressions at a median rate of 112 (IQR 104-118) compressions per minute vs. 105 (IQR 101-113) compressions per minute for mattress participants (<i>p</i> = 0.12). Using a survival analysis, the time to failure was not statistically different between surfaces (<i>p</i> = 0.4).</p><p><strong>Conclusions: </strong>This prospective pilot study suggests no difference in fatigability of a person performing CPR on a mattress versus a floor. Further study is necessary to validate our findings.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042913","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":"Federal Controlled Substance Actions and Wildland Fire EMS Operations.","authors":"Seth C Hawkins, Sarah Frances McClure, Brian Drury","doi":"10.1080/10903127.2026.2684017","DOIUrl":"10.1080/10903127.2026.2684017","url":null,"abstract":"","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-2"},"PeriodicalIF":2.0,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199719","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":"Identifying Themes for EMS Continued Competency That Are Acceptable and Improve Patient Care.","authors":"Ashish R Panchal, Kayla M Riel, Jacob C Kamholz, Christopher B Gage, Shea L van den Bergh, Mihaiela R Gugiu","doi":"10.1080/10903127.2026.2674829","DOIUrl":"10.1080/10903127.2026.2674829","url":null,"abstract":"<p><strong>Objectives: </strong>Continued competency in emergency medical services (EMS) remains inconsistently defined, and existing frameworks have not been systematically reevaluated to ensure alignment with contemporary EMS practice, acceptability to clinicians, and relevance to patient care. The objective of this study was to derive and prioritize foundational principles to guide development of an updated EMS continued competency model that would be acceptable to EMS clinicians and support improvement in competency and patient care.</p><p><strong>Methods: </strong>We conducted a four-round, in-person modified qualitative Delphi study with a multidisciplinary panel of EMS subject matter experts, including frontline clinicians, educators, medical directors, agency leaders, and state EMS officials. In Round 1, panelists responded to open-ended prompts to generate concepts related to acceptable and effective continued competency models. These inputs were synthesized into themes and iteratively refined through structured group discussion. In Round 2, panelists rated each theme for acceptability to EMS clinicians and perceived impact on competency and patient care using five-point Likert-type scales. In Round 3, themes meeting predefined cut criteria were rank ordered. In Round 4, panelists engaged in consensus-building discussions to identify a prioritized set of principles. Consensus was defined a priori as at least 75% agreement.</p><p><strong>Results: </strong>Fifteen experts participated in all Delphi rounds, contributing several hundred open-ended responses that were synthesized into 22 unique themes. Through iterative refinement and ranking, the panel achieved unanimous consensus on five foundational principles to guide an updated EMS continued competency model: educational content must be evidence-based; EMS clinicians must have an active role in competency development; assessment priorities should be informed by quality assurance and quality improvement data; competency assessment should be non-punitive and growth oriented; and the model must be feasible and scalable across EMS settings. Four additional themes were identified as operational strategies that support implementation, including simulation-based assessment, longitudinal competency development, microlearning, and technology-enabled delivery.</p><p><strong>Conclusions: </strong>Using expert consensus, this modified Delphi study identified a set of foundational and operational principles to guide development of an updated EMS continued competency model. These findings provide a structured, evidence-informed framework to support future design, evaluation, and implementation efforts across diverse EMS systems.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205828","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":"Service Ready Ambulance Surfaces and Emergency Medical Services Clinicians are Routinely Contaminated with Clinically Important Pathogens.","authors":"Diego Schaps, Bobby G Warren, Julia Isaacson, Amanda M Graves, Aaron Barrett, Carly King, Andrew W Godfrey, Anjni Patel Joiner, Deverick J Anderson","doi":"10.1080/10903127.2026.2681882","DOIUrl":"10.1080/10903127.2026.2681882","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize contamination of ambulances and emergency medical services (EMS) clinicians with clinically important pathogens (CIPs) before and after a shift.</p><p><strong>Methods: </strong>Prospective observational study of 20 ambulances from two EMS agencies (10 nonemergency transport, 10 emergency 9-1-1) from September 2021 to March 2022. Samples were collected from patient-facing and clinician-facing surfaces, EMS uniforms, and right nostril before a shift and after a shift but prior to post-shift cleaning. Ambulance surfaces were disinfected by study staff after pre-shift sampling to establish a near-zero reference. The CIPs included methicillin-resistant and methicillin-sensitive <i>Staphylococcus aureus</i> (MRSA, MSSA), vancomycin-resistant <i>Enterococcus</i> (VRE), and <i>Clostridioides difficile</i>. The EMS clinicians completed surveys on hygiene behaviors and beliefs. Primary outcome was presence of ≥1 CIP at an individual sampling site.</p><p><strong>Results: </strong>Across 20 ambulances and 27 EMS clinicians, 941 samples were collected. Overall, 18.5% harbored ≥1 CIP. MSSA was most common (12.8%), followed by MRSA (4.6%) and VRE (3.0%). <i>Clostridioides difficile</i> was rare (0.1%). When deemed service ready, 63.1% of EMS clinicians and 60% of ambulances had ≥1 CIP. Post-shift contamination remained similar (EMS clinicians 67.6%, ambulances 60%). Emergency 9-1-1 ambulances had higher contamination than nonemergency ambulances. EMS clinicians reported high awareness of the importance of clean uniforms and vehicles.</p><p><strong>Conclusions: </strong>EMS clinicians and ambulances harbor CIPs when deemed service ready and contamination accumulates during shifts. Pre-shift uniform contamination suggests clinicians may be sources of medical transport setting contamination. Improved uniform hygiene, rigorous terminal cleaning, and targeted interventions are needed to reduce medical transport-associated infection risk.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144460","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":"Feasibility of Electric Vehicle Adoption in US Ambulance Fleets: A Retrospective Analysis of NEMSIS Data.","authors":"Patrick J Maher, Dustin Gonzalez, Nicole D'Arcy","doi":"10.1080/10903127.2026.2677167","DOIUrl":"10.1080/10903127.2026.2677167","url":null,"abstract":"<p><strong>Objectives: </strong>The transition to electric vehicles (EVs) represents a potential strategy for reducing carbon emissions from the health care sector. Ambulances, however, have unique operational demands, including rapid response times, variable call volumes, and prolonged periods at hospitals. Using data from the National Emergency Medical Services Information System (NEMSIS) in 2024, we modeled the feasibility for implementing EV ambulances in multiple response environments, as well as the possible benefits of providing at-hospital charging at various speeds.</p><p><strong>Methods: </strong>We used an observational study design and retrospective analysis to assess the average time on task and estimated driving distances for EMS 9-1-1 calls stratified by urbanicity. These ranges were tested against two hypothetical operating profiles of electric ambulances to assess practicality, assuming a 25% remaining battery capacity at hospital arrival. Potential models for at-hospital charging were evaluated using different charging rates.</p><p><strong>Results: </strong>Estimated mileage fell within range requirements for most cases, ranging from 99.9% of dispatches for urban settings with a higher-capacity vehicle to 97.6% of dispatches in frontier settings for a lower-capacity vehicle type. Assuming charging time to span from ambulance arrival at hospital to return to service, both Level-2 and Level-3 charging stations restored significant fractions of total energy used during transport.</p><p><strong>Conclusions: </strong>Electric ambulance battery capacity ranges cover the majority of distances required by single dispatches across multiple urbanicity settings, but higher-capacity battery vehicles may be more consistently reliable in rural or frontier settings. Incorporating at-hospital charging stations may offset a significant portion of charging time requirements. Benefits of reductions in vehicle emissions likely differ according to local power grid composition.</p>","PeriodicalId":20336,"journal":{"name":"Prehospital Emergency Care","volume":" ","pages":"1-6"},"PeriodicalIF":2.0,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043216","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}