Tag: Research

Publication, Research

Routine Use of a Bougie Improves First-Attempt Intubation Success in the EMS Setting

Study objective The bougie is typically treated as a rescue device for difficult airways. We evaluate whether first-attempt success rate during paramedic intubation in the out-of-hospital setting changed with routine use of a bougie. Methods A prospective, observational, pre-post study design was used to compare first-attempt success rate during out-of-hospital intubation with direct laryngoscopy for patients intubated 18 months before and 18 months after a … Continue reading Routine Use of a Bougie Improves First-Attempt Intubation Success in the EMS Setting

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Publication, Research

EMS and DNAR directives among patients with OHCA

Background: Emergency Medical Services (EMS) are often involved in end-of-life circumstances, yet little is known about how EMS interfaces with advance directives to forego unwanted resuscitation (Do Not Attempt Resuscitation (DNAR)). We evaluated the frequency of these directives involved in out-of-hospital cardiac arrest (OHCA) and how they impact care. Methods: We conducted a cohort investigation of adult, EMS-attended OHCA from January 1 to December 31, 2018 in … Continue reading EMS and DNAR directives among patients with OHCA

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Publication

Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

We undertook a cohort investigation of OHCA attended by emergency medical services (EMS) in Seattle and King County, WA from January 1 to April 15, 2020. Patients where EMS attempted resuscitation (EMS treated) and where EMS responded but did not provide resuscitation because of signs of irreversible death (dead on EMS arrival) were included. Our population-based OHCA registry systematically abstracts information about OHCA presentation, treatment, and outcome from dispatch audio recordings, defibrillator electronic data, prehospital … Continue reading Prevalence of COVID-19 in OHCA: Implications for Bystander CPR

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EMS1

Research Analysis: Preventing downstream consequences of EMS assaults

The National Association of EMTs (NAEMT) recently published a survey on member experiences with violence in the prehospital setting. They received nearly 2,200 responses from mostly paramedics and EMTs detailing not only their exposure to violence, but also the role violence plays on their perceptions of safety, provider knowledge of reporting systems, agency policies and procedures, as well as the types of education and training … Continue reading Research Analysis: Preventing downstream consequences of EMS assaults

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EMS1

Research Analysis: Status epilepticus: Pick your antidote

Results from the Established Status Epilepticus Treatment Trial (ESETT) were recently published in New England Journal of Medicine (NEJM), providing medical directors with a research-centric resource to turn to when epileptic patients don’t respond to traditional benzodiazepines. Specifically, ESETT was an NIH and FDA funded joint effort by the Neurological Emergencies Treatment Trials (NETT) Network and the Pediatric Emergency Care Applied Research Network (PECARN) in … Continue reading Research Analysis: Status epilepticus: Pick your antidote

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Publication

Causes of Chest Compression Interruptions During OHCA

Abstract Background Interruptions in chest compressions contribute to poor outcomes in out‐of‐hospital cardiac arrest. The objective of this retrospective observational cohort study was to characterize the frequency, reasons, and duration of interruptions in chest compressions and to determine if interruptions changed over time. Methods and Results All out‐of‐hospital cardiac arrests treated by the Seattle Fire Department (Seattle, WA, United States) from 2007 to 2016 with … Continue reading Causes of Chest Compression Interruptions During OHCA

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Publication

Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study

Abstract Objectives: To determine the association between targeted temperature managementgoal temperature of 33°C versus 36°C and neurologic outcome after out-of-hospital cardiac arrest. Design: This was a retrospective, before-and-after, cohort study. Setting: Urban, academic, level 1 trauma center from 2010 to 2017. Patients: Adults with nontraumatic out-of-hospital cardiac arrest who received targeted temperature management. Interventions: Our primary exposure was targeted temperature management goal temperature, which was changed from 33°C to 36°C in April of 2014 at the study hospital. Primary … Continue reading Targeted Temperature Management at 33 Versus 36 Degrees: A Retrospective Cohort Study

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EMS1

Research analysis: Using continuous feedback to drive cardiac arrest care improvements

The Municipal Emergency Medical Services of Vienna implemented a standardized post-resuscitation feedback system and performed a two-year evaluation of its impact on performance and patient outcomes. They recently published their results in “Resuscitation.” Within 48 hours of every out-of-hospital cardiac arrest (OHCA) from August 2013 through July 2015 (n = 2466) providers received comprehensive feedback on their performance related to “compression rate, compression ratio, ventilation … Continue reading Research analysis: Using continuous feedback to drive cardiac arrest care improvements

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Publication

Machine learning as a supportive tool to recognize cardiac arrest in emergency calls

Background Emergency medical dispatchers fail to identify approximately 25% of cases of out of hospital cardiac arrest, thus lose the opportunity to provide the caller instructions in cardiopulmonary resuscitation. We examined whether a machine learning framework could recognize out-of-hospital cardiac arrest from audio files of calls to the emergency medical dispatch center. Methods For all incidents responded to by Emergency Medical Dispatch Center Copenhagen in … Continue reading Machine learning as a supportive tool to recognize cardiac arrest in emergency calls

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EMS1

Research Analysis: More than 1-in-20 EMT deaths are due to suicide

A study out of the University of Arizona College of Medicine was recently published online in Preshospital Emergency Care. The researchers looked at all deaths that occurred in Arizona, as well as the deaths of Arizona residents in another state or country, between 2009 and 2015. Of the 350,998 adult deaths recorded, all were categorized as either suicide or non-suicide via the listed ICD-10 code. The suicides were then further … Continue reading Research Analysis: More than 1-in-20 EMT deaths are due to suicide

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