Article
Clinical Neurology
Karianne Larsen, Henriette S. Jaeger, Maren R. Hov, Kjetil Thorsen, Volker Solyga, Christian G. Lund, Kristi G. Bache
Summary: The study indicates that paramedics can effectively use NIHSS as an accurate and time efficient prehospital stroke severity quantification tool, early assessment of strokes can be beneficial for stroke treatment.
Article
Emergency Medicine
Cameron J. J. Gettel, D. Mark Courtney, Pooja Agrawal, Tracy E. E. Madsen, Craig Rothenberg, Angela M. M. Mills, Michelle D. D. Lall, Samuel M. M. Keim, Chadd K. K. Kraus, Megan L. L. Ranney, Arjun K. K. Venkatesh
Summary: This study aimed to investigate the age and number of years since residency graduation at which male and female emergency physicians exhibit attrition from the workforce. The results showed that female physicians exhibited attrition approximately 12 years younger than male physicians. These findings highlight the widespread disparities regarding attrition in the emergency medicine workforce, which need to be addressed to ensure stability, longevity, and diversity.
ACADEMIC EMERGENCY MEDICINE
(2023)
Article
Medicine, General & Internal
Feng Xie, Jiajun Yan, Gina Agarwal, Richard Ferron
Summary: This study compared the time on task and cost between Mobile integrated health care (MIH) and ambulance services provided by Niagara emergency medical services (NEMS). The results showed that MIH was associated with a shorter service time, lower proportion of patients transported to the emergency department, and lower total costs compared to regular ambulance responses.
Article
Radiology, Nuclear Medicine & Medical Imaging
Eva Bezak, John Damilakis, Madan M. Rehani
Summary: According to a survey conducted by the International Organization for Medical Physics (IOMP), there is an imbalance in the distribution of medical physicists worldwide, with a higher number in high-income countries and a lower number in middle and low-income countries. The survey also revealed a shortage of medical physicists in many countries. Moreover, most countries have official training programs for medical physicists and offer university courses in medical physics.
PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS
(2023)
Article
Pharmacology & Pharmacy
D. M. Al Razeeni, A. Al-Wathinani, R. Alhazmi, O. A. Samarkandi, S. A. Ronal, Basma Salameh, A. Alenazi
Summary: Emergency medical services students in Saudi Arabia feel inadequately prepared to face situations like the coronavirus disease 2019 outbreak. They express the need for more training on pandemic-related knowledge and skills.
INDIAN JOURNAL OF PHARMACEUTICAL SCIENCES
(2021)
Article
Public, Environmental & Occupational Health
Bram Duffee, David Blake Willis
Summary: The time for ambulance paramedics to determine the differential diagnosis of a patient after receiving a 911 alarm notification is highly stressful, with high demand and low control. Through interviews with twenty paramedics across the United States, six categories were identified in their responses: pressure, overwhelm, emotional extremes, dissociation, multi-tasking, and disconnect. Understanding the unique stress experienced by paramedics in high-stakes situations is crucial for assessing the impact on judgment and care, and addressing these issues can reduce turnover and burnout among paramedics.
SOCIAL SCIENCE & MEDICINE
(2023)
Article
Public, Environmental & Occupational Health
Jessica N. Jeruzal, Lori L. Boland, Diana Jin, Christie L. Traczyk, Nathan D. Shippee, Hannah T. Neprash, Andrew C. Stevens
Summary: This study examined trends in fall-related EMS utilization among adult patients from 2010 to 2018, described incident characteristics by age, and identified factors associated with non-transport following a fall. Factors such as location of the incident, previous fall history, and lack of apparent illness or injury upon assessment were found to be strongly associated with non-transport decisions.
HEALTH & SOCIAL CARE IN THE COMMUNITY
(2022)
Article
Emergency Medicine
I. E. Blanchard, T. S. Williamson, P. Ronksley, B. Hagel, D. Niven, S. Dean, M. N. Shah, E. S. Lang, C. J. Doig
Summary: Linking EMS data to ED outcomes through an optimized sequential deterministic strategy improved linkage rates without increasing false positive links and reduced bias potential. Some records may not be linked to their ED visit even with adequate information.
PREHOSPITAL EMERGENCY CARE
(2022)
Article
Education & Educational Research
Tomas Nilsson, I. Masiello, E. Broberger, V. Lindstrom
Summary: The use of a digitalized assessment tool for formative assessment in the Emergency Medical Services (EMS) was perceived positively by nursing students and clinical supervisors. The tool provided opportunities for reflection, visualized strengths and areas of improvement, and displayed progress using a Likert scale. The application improved communication and transparency in assessments.
BMC MEDICAL EDUCATION
(2023)
Article
Emergency Medicine
Madison K. Rivard, Rebecca E. Cash, Christopher B. Mercer, Kirsten Chrzan, Ashish R. Panchal
Summary: This study aims to describe the roles and settings in which nationally certified EMS professionals provide patient care, and evaluate the demographic and practice setting differences among the three major certification levels. The results show that the majority of EMS professionals are male, with age increasing by certification level, and a significant proportion are white.
PREHOSPITAL EMERGENCY CARE
(2021)
Article
Management
Samuel Ridler, Andrew J. Mason, Andrea Raith
Summary: This paper introduces JEMSS, a free and open-source software package for simulation and optimization of Emergency Medical Services (EMS). JEMSS incorporates integer programming optimization, heuristic local search, and simulation capabilities to evaluate and optimize EMS decision-making and strategies. The package includes flexible and customizable decision protocols for ambulance dispatch and dynamic redeployment. It runs simulations quickly, allowing for efficient evaluation of realistic city models. The software also includes visualization tools and has been validated against existing EMS simulation software.
EUROPEAN JOURNAL OF OPERATIONAL RESEARCH
(2022)
Review
Anesthesiology
J. Critchley, M. Schwarz, R. Baruah
Summary: In the UK, the proportion of female medical students has remained stable, but only 36.6% of doctors at consultant level are women. This article discusses issues affecting female medical workforce, including gender stereotypes and implicit gender bias.
Article
Transportation Science & Technology
Gaby Joe Hannoun, Monica Menendez
Summary: Advancements in vehicular and wireless communication technologies have shaped the future of transportation systems, but emergency medical services (EMS) still face issues with response delays. This research introduces a smart EMS system using modular vehicle technology to improve resource allocation and rescue efficiency. Results show that the system can respond quicker to emergencies, especially in large-scale disaster scenarios.
TRANSPORTATION RESEARCH PART C-EMERGING TECHNOLOGIES
(2022)
Article
Public, Environmental & Occupational Health
Ahmed Ramdan M. Alanazy, John Fraser, Stuart Wark
Summary: This study examines the experiences of Saudi Arabian EMS personnel and finds disparities in availability, accessibility, and resources between rural and urban areas. The lack of local training and resources in rural areas, as well as issues with EMS staff demographics and public awareness, are identified as key concerns. The study recommends specialized training and ongoing education, supplementing EMS with external specialists, and implementing national public education programs.
HEALTH & SOCIAL CARE IN THE COMMUNITY
(2022)
Article
Economics
Marcos Colla, Gilson Ditzel Santos, Gilson Adamczuk Oliveira, Renata Braga Berenguer de Vasconcelos
Summary: Research on ambulance response times for EMS calls has been conducted for decades, primarily in developed countries. However, there is limited scientific research on this topic in Brazil, a developing country, which mainly focuses on cities with a population of over one million. This highlights the need to extend research to small and medium-sized cities.
SOCIO-ECONOMIC PLANNING SCIENCES
(2023)
Article
Emergency Medicine
George Lindbeck, Manish Shah, Sabina Braithwaite, Jonathan R. Powell, Ashish R. Panchal, Lorin R. Browne, Eddy S. Lang, Brooke Burton, Jeffrey Coughenour, Remle P. Crowe, Hannah Degn, Mary Hedges, James Gasper, Kyle Guild, Connie Mattera, Sandra Nasca, Peter Taillac, Mark Warth
Summary: This project aimed to develop evidence-based guidelines for the administration of analgesics in EMS settings. The panel made several recommendations, highlighting the importance of non-opioid analgesics in the management of acute pain.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Jonathan R. Powell, Lorin R. Browne, Kyle Guild, Manish Shah, Remle P. Crowe, George Lindbeck, Sabina Braithwaite, Eddy S. Lang, Ashish R. Panchal
Summary: This study describes a protocol that used established evidence-based guideline (EBG) development techniques, the GRADE framework, and a previous AHRQ systematic review to develop treatment recommendations for prehospital pain management. The process utilized virtual and electronic communication to mitigate confounders and may inform future guideline development and enhance transparency in the prehospital recommendations development processes.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Mihaiela R. Gugiu, Kim D. McKenna, Thomas E. Platt, Ashish R. Panchal
Summary: This article discusses the challenges faced by EMS clinicians in the prehospital setting and proposes a theoretical framework for clinical judgment to address these challenges.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Travis Sharkey-Toppen, Jordan D. Kurth, Osama Saadoon, Betty Yang, Emily Gibbons, Jonathan R. Powell, Ashish R. Panchal
Summary: This study aims to describe the requirements to be an EMS medical director in different states of the US. The results show that the requirements for EMS medical direction are not standardized across different states, with many states only requiring a medical license without emergency medicine board certification.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Alix Delamare Fauvel, Jonathan R. Powell, Jordan D. Kurth, Henry E. Wang, Ashish R. Panchal
Summary: Emergency medical services (EMS) are crucial in providing prehospital emergency care. This study found that 17% of EMS clinicians are in non-patient care roles, and the likelihood of working in these roles is associated with demographic and workforce experience characteristics.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Christian Martin-Gill, Ashish R. Panchal, Rebecca E. Cash, Christopher T. Richards, Kathleen M. Brown, P. Daniel Patterson
Summary: Evidence-based guidelines are increasingly being published to inform the EMS community, but their quality varies. This can negatively impact dissemination, education, and implementation efforts. This article describes the current state of published guidelines, provides a description of key elements and methods to assess their quality, and offers recommendations for improving evidence evaluation, guideline development, and reporting.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Emergency Medicine
Rebecca E. Cash, Scott A. Goldberg, Jonathan R. Powell, Gregory A. Peters, Ashish R. Panchal, Carlos A. A. Camargo Jr
Summary: This study examined the geographic distribution and density of EMS personnel in the U.S. It found that EMS personnel density is higher in rural areas compared to urban areas. There were significant associations between EMS density and life expectancy and all-cause mortality, but these associations became non-significant after adjusting for population characteristics and other health resources.
PREHOSPITAL EMERGENCY CARE
(2023)
Review
Clinical Neurology
Christopher T. T. Richards, J. Adam Oostema, Sherita N. N. Chapman, Lauren E. E. Mamer, Ethan S. S. Brandler, Anne W. W. Alexandrov, Alexandra L. L. Czap, Juan Carlos Martinez-Gutierrez, Christian Martin-Gill, Ashish R. R. Panchal, Jason T. T. McMullan, Kori S. S. Zachrison
Summary: This topical review discusses the current state of prehospital acute stroke screening and transport, as well as new and emerging advances in prehospital diagnosis and treatment of acute stroke. Topics include prehospital stroke screening, stroke severity screening, emerging technologies to aid in the identification and diagnosis of acute stroke in the prehospital setting, prenotification of receiving emergency departments, decision support for destination determination, and the capabilities and opportunities for prehospital stroke treatment in mobile stroke units. Further evidence-based guideline development and implementation of new technologies are critical for ongoing improvements in prehospital stroke care.
Article
Cell Biology
Panke Qu, Julia N. Faraone, John P. Evans, Yi-Min Zheng, Claire Carlin, Mirela Anghelina, Patrick Stevens, Soledad Fernandez, Daniel Jones, Ashish R. Panchal, Linda J. Saif, Eugene M. Oltz, Baoshan Zhang, Tongqing Zhou, Kai Xu, Richard J. Gumina, Shan-Lu Liu
Summary: This study demonstrates the nearly complete escape of XBB.1.5, CH.1.1, and CA.3.1 variants from neutralizing antibodies stimulated by mRNA vaccine or BA.4/5 wave infection, but neutralization can be rescued by a bivalent booster containing BA.5. CH.1.1 and CA.3.1 also show strong immune escape from monoclonal antibody S309. Furthermore, the spike proteins of XBB.1.5, CH.1.1, and CA.3.1 exhibit enhanced fusogenicity and processing compared to BA.2.
Article
Emergency Medicine
Christopher B. Gage, Mark Terry, Kim D. McKenna, Jonathan R. Powell, Megan Hollern, Matt Ozanich, Christopher T. Richards, Christian Martin-Gill, Ashish R. Panchal
Summary: To reflect evidence-based out-of-hospital care, it is important to incorporate emerging knowledge into Emergency Medical Service (EMS) competency assessments. A framework, called the Table of Evidence, has been developed using a Delphi method to define the sources and quality of EMS evidence and provide integration recommendations.
PREHOSPITAL AND DISASTER MEDICINE
(2023)
Article
Cell Biology
Julia N. Faraone, Panke Qu, John P. Evans, Yi-Min Zheng, Claire Carlin, Mirela Anghelina, Patrick Stevens, Soledad Fernandez, Daniel Jones, Gerard Lozanski, Ashish Panchal, Linda J. Saif, Eugene M. Oltz, Richard J. Gumina, Shan-Lu Liu
Summary: New Omicron subvariants are continuously emerging worldwide. The XBB subvariant, a recombinant virus between BA.2.10.1.1 and BA.2.75.3.1.1.1, as well as the BA.2.3.20 and BR.2 subvariants with distinct mutations from BA.2 and BA.2.75, are increasing in proportion. Antibodies induced by 3-dose mRNA booster vaccination and previous BA.1-and BA.4/5-wave infection effectively neutralize BA.2, BR.2, and BA.2.3.20, but have reduced efficiency against XBB. The BA.2.3.20 subvariant exhibits enhanced infectivity in lung-derived CaLu-3 cells and 293T-ACE2 cells. Continued monitoring of immune escape and tissue tropism of emerging Omicron subvariants is crucial.
CELL REPORTS MEDICINE
(2023)
Article
Emergency Medicine
Michael Kaduce, Jonathan R. Powell, Lisa Collard, Christopher B. Gage, Michael G. Miller, Ashish R. Panchal
Summary: In our analysis of the 2018 annual report of paramedic programs in the US, we found common deficiencies in resources for graduating paramedic students, such as lack of medical director engagement, facility issues, and inadequate financial resources.
PREHOSPITAL EMERGENCY CARE
(2023)
Article
Critical Care Medicine
Christopher B. Gage, Jonathan R. Powell, Michelle Nassal, Henry Wang, Ashish R. Panchal
Summary: This study in the US found that over the past decade, the use of advanced airways in out-of-hospital cardiac arrest has increased, with endotracheal intubation remaining the primary airway choice for adults, but supraglottic airway use has been steadily increasing. In urban settings, there was a significant increase in supraglottic airway usage, while rural and suburban areas remained stable in their usage.
