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
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
Amelia Breyre, Michael Taigman, Angelo Salvucci, Karl Sporer
Summary: The Mobile Integrated Hospice Healthcare program effectively reduced transportation of hospice patients to the Emergency Department through hospice education and training for paramedics. However, expanding the scope of practice did not contribute to the decrease in patient transportation.
PREHOSPITAL EMERGENCY CARE
(2022)
Article
Emergency Medicine
Tucker Lurie, Srikar Adibhatla, Gail Betz, Jamie Palmer, Alison Raffman, Sanketh Andhavarapu, Andrea Harris, Quincy K. Tran, Daniel B. Gingold
Summary: Mobile Integrated Health Community Paramedicine (MIH-CP) programs aim to increase access to care and reduce emergency department and emergency medical services usage. Previous systematic reviews on MIH-CP reported diverse interventions, effect sizes, and a high prevalence of biased methods. This study performed a meta-analysis to evaluate the effect of MIH-CP on emergency department visits and assessed the influence of study designs on reported effect sizes. The results showed a reduced risk of emergency department visits associated with MIH-CP programs.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Emergency Medicine
Ryan P. Strum, Fabrice I. Mowbray, Andrew Worster, Walter Tavares, Matthew S. Leyenaar, Rebecca H. Correia, Andrew P. Costa
Summary: The study found that mode of transportation to the emergency department affects hospital admission rates, with paramedic transport having a higher likelihood of admission compared to self-referral visits. Factors independently associated with hospital admission include medical acuity, age, gender, number of comorbidities, treatment setting, and specific discharge diagnoses. These findings can inform proactive healthcare strategies for in-patient bed management.
BMC EMERGENCY MEDICINE
(2021)
Article
Health Care Sciences & Services
Tshepo Nelson Maake, Bernadette Theresa Millar, Lloyd Denzil Christopher, Navindhra Naidoo
Summary: This qualitative study examines racial discrimination experiences in the Emergency Medical Care (EMC) field in South Africa post-apartheid. Results showed that EMC students faced discrimination based on race and gender during work-integrated learning. Language barriers intentionally isolated students from patients, hindering their clinical decision-making and potentially impacting patient care.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Public, Environmental & Occupational Health
Ali Azimi, Nasser Bagheri, Sayyed Mostafa Mostafavi, Mary Anne Furst, Soheil Hashtarkhani, Fateme Hashemi Amin, Saeid Eslami, Fatemeh Kiani, Reza VafaeiNezhad, Toktam Akbari, Amin Golabpour, Behzad Kiani
Summary: The study found that the number of cardiovascular emergency calls increased annually from 2017 to 2019, with the highest call volume on Saturday nights. Spatial and temporal clustering were identified in the study area, with significant differences in response time.
Article
Medicine, Research & Experimental
Jennifer L. Ridgeway, Erin O. Wissler Gerdes, Andrew Dodge, Chad P. Liedl, Michael B. Juntunen, Wendy J. S. Sundt, Amy Glasgow, Michelle A. Lampman, Angela L. Fink, Sara B. Severson, Grace Lin, Richard R. Sampson, Robert P. Peterson, Brian M. Murley, Aaron B. Klassen, Anuradha Luke, Paul A. Friedman, Tamara E. Buechler, James S. Newman, Rozalina G. McCoy
Summary: The objective of this study is to evaluate the effectiveness and implementation of the Care Anywhere with Community Paramedics program in shortening and preventing acute care utilization. The study includes formative evaluation methods and assessment of implementation outcomes, and aims to provide robust evidence for the program's effectiveness and inform best practices for scale-up and sustainability.
Article
Geosciences, Multidisciplinary
Chengwen Wang, Li Xiong, Houcai Wang
Summary: This research explores an epidemic medical service allocation model from an integrated healthcare perspective, aiming to enhance the overall regional emergency medical service capability based on collaborative medical treatment. The model addresses the dispersed medical service resources and demands in a certain region, and realizes the division of labor and resource sharing among medical institutions.
INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION
(2022)
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
Public, Environmental & Occupational Health
Philipp Dahlmann, Simone Boebel, Christian Friess, Maresa Neuerer
Summary: Societal developments have led to increased demand on emergency care and EMS systems due to geriatric, psychosocial, and non-time-critical emergencies. Proper training of emergency paramedics is essential in meeting evolving patient needs. Community paramedics and telemedical support systems offer opportunities to enhance patient care. Patient safety and patient centeredness should be guiding principles, requiring continuous training and innovative cross-sectoral care concepts.
BUNDESGESUNDHEITSBLATT-GESUNDHEITSFORSCHUNG-GESUNDHEITSSCHUTZ
(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
Medicine, General & Internal
Brian Haskins, Ziad Nehme, Peter A. Cameron, Karen Smith
Summary: Comparing the frequency and outcomes of cardiac arrests in general practice clinics with those of paramedic-witnessed cardiac arrests, the study found that survival rates were higher in cases witnessed by paramedics. It was suggested that prompt alerting of emergency medical services and availability of automated external defibrillators in general practice clinics could significantly reduce the risk of death for cardiac arrest patients.
MEDICAL JOURNAL OF AUSTRALIA
(2021)
Article
Health Care Sciences & Services
Alix J. E. Carter, Rebecca Earle, Marie-Claude Gregoire, Grace MacConnell, Todd MacDonald, Gerri Frager
JOURNAL OF PALLIATIVE MEDICINE
(2020)
Article
Management
Mengyu Li, Alix Carter, Judah Goldstein, Terence Hawco, Jan Jensen, Peter Vanberkel
Summary: The study aims to develop an ambulance destination policy to mitigate ambulance offload delay (AOD), improve patient access to care, and expedite ambulance return to service. By utilizing a MDP model and policy iteration algorithm, an optimal ambulance destination policy is created, showing significant reductions in AOD, patient time to bed, and paramedic out-of-service time, albeit with increased ambulance travel distances. This model can be utilized as a decision support tool for EMS systems to manage the impact of AOD on their operations.
OMEGA-INTERNATIONAL JOURNAL OF MANAGEMENT SCIENCE
(2021)
Article
Management
Molly Elliott, T. Peter Vanberkel, J. E. Alix Carter
JOURNAL OF THE OPERATIONAL RESEARCH SOCIETY
(2020)
Article
Emergency Medicine
Jolene Cook, Alix Carter, Judah Goldstein, Andrew Travers, Ryan Brown, Janel Swain, Jan Jensen, Kara Matheson, Ed Cain, Tony Lee
PREHOSPITAL AND DISASTER MEDICINE
(2020)
Article
Emergency Medicine
Philip J. Davis, Justin Yan, Kerstin de Wit, Patrick M. Archambault, Andrew McRae, David W. Savage, Naveen Poonai, Marco L. A. Sivilotti, Alix Carter, Shelley L. McLeod
Summary: This study developed practical recommendations for starting, building and sustaining a research program in emergency medicine in Canada with limited infrastructure and/or research experience. The recommendations cover how to start, build and sustain a research program in emergency medicine, providing 15 pragmatic suggestions for centers without an established research culture, as well as four recommendations for department leads aiming to foster a research program within their departments.
CANADIAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Review
Psychiatry
Candice E. Crocker, Alix J. E. Carter, Jason G. Emsley, Kirk Magee, Paul Atkinson, Philip G. Tibbo
Summary: Cannabis use is associated with the development and exacerbation of mental illness, especially the risk of psychotic disorder. In emergency situations, cannabis-related adverse mental health events such as anxiety, suicidal thoughts, and psychotic symptoms are significant, particularly in youth and young adults. The differences in impact between alcohol and cannabis on emergency mental health services highlight the need for tailored interventions based on individual risk factors.
FRONTIERS IN PSYCHIATRY
(2021)
Article
Emergency Medicine
Steven Carrigan, Judah Goldstein, Alix Carter, Yukiko Asada, Andrew Travers
Summary: This study analyzed EMS data to determine the prevalence of non-transport and 48-hour adverse events, as well as identify characteristics associated with these outcomes. The results showed that younger age, nonspecific paramedic clinical impression, more than 7 comorbidities, and incident location (jail) were significantly associated with non-transport and adverse events.
JOURNAL OF EMERGENCY MEDICINE
(2022)
Review
Emergency Medicine
Marissa Hurtubise, Jeffery Stirling, Jennifer Greene, Alix J. E. Carter, Janel Swain, Ryan Brown, Dana Fidgen, Judah P. Goldstein
Summary: The study results indicate that 10% dextrose may be as effective as 50% dextrose in resolving symptoms and correcting hypoglycemia. Although the desired effect may take longer, there appear to be fewer adverse events in the D10 group, and post-D10-treatment blood glucose levels may be lower as well.
PREHOSPITAL AND DISASTER MEDICINE
(2021)
Article
Health Care Sciences & Services
Alix J. E. Carter, Michelle Harrison, Jennifer Kryworuchko, Tjingaita Kekwaletswe, Sabrina T. Wong, Judah Goldstein, Grace Warner
Summary: The study identified key elements for implementing the Paramedics Providing Palliative Care at Home Program, including the importance of inter-sectoral communication, locally adapted training, a shift in mindset away from traditional paramedic roles, and early engagement of diverse stakeholders with planning for sustainability. The framework analysis using CFIR constructs highlighted essential elements for successful scale and spread of the program, such as cosmopolitanism, adaptability, implementation climate, engagement, and planning.
JOURNAL OF PALLIATIVE MEDICINE
(2022)
Article
Emergency Medicine
Alix J. E. Carter, Michelle Harrison, Judah Goldstein, Marianne Arab, Jan Jensen, Katherine Houde, Robin Urquhart
Summary: This study explored the alignment of providing palliative support at home with paramedic professional identity. The findings demonstrated the evolution of paramedic role and professional identity, highlighting the importance of novel roles like providing palliative care in the healthcare system.
CANADIAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Emergency Medicine
Jan L. Jensen, Fahd Al-Dhalaan, Jennifer Rose, Alix Carter, Jennifer McVey, Francine Butts, Terence Hawco, Peter Rose, Andrew H. Travers
Summary: This study compared the consultation patterns, transport dispositions, and patient safety measures of direct medical oversight physician consults with CSD peer-to-peer consults in a provincial EMS system. The introduction of the CSD led to an increase in consults and a decrease in call volume for physicians, with no change in patient safety measures.
PREHOSPITAL EMERGENCY CARE
(2022)
Article
Public, Environmental & Occupational Health
Alexandra J. E. Carter, Marianne Arab, Cheryl Cameron, Michelle Harrison, Charlotte Pooler, Ian McEwan, Michael Austin, Jennie Helmer, Gurkan Ozel, Jessica Heathcote, Natalie Reardon, Elizabeth Anderson, Megan Carey, Raquel Shaw Moxam, Shelly Crick
Summary: A national collaborative in Canada has been launched to spread and scale up the Paramedics Providing Palliative Care model, which aims to improve the palliative and end of life experience for patients with palliative care needs and their families. Stakeholder engagement and inter-sectoral collaboration are crucial for the success of this innovative approach to care.
PROGRESS IN PALLIATIVE CARE
(2021)
Article
Emergency Medicine
A. P. Javidan, K. Hansen, I. Higginson, P. Jones, E. Lang
Summary: The IFEM report aims to address emergency department crowding and access block issues, requiring systemic solutions. Access block is the predominant contributor of ED crowding in most parts of the world.
INTERNATIONAL JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Computer Science, Interdisciplinary Applications
Lauren McNamara, Peter T. Vanberkel, David Petrie, Alix J. E. Carter
COMPUTERS & INDUSTRIAL ENGINEERING
(2020)