Impact of Providing Peer Support on Medical Students' Empathy, Self-Efficacy, and Mental Health Stigma.

Background: Peer-support programs in medical school can buffer feelings of inadequacy, anxiety, social isolation, and burnout, drawing upon the benefits of near-peer-support resources. This study examined the effects of providing support to students in a medical school peer-support program.

Methods: Using a pre-post, quasi-experimental study design, the investigators surveyed medical students who were peer supporters in their second through fourth years of medical school with four measures assessing (1) empathy, (2) self-efficacy, (3) mental health stigma, and (4) likelihood to assist peers with mental health problems to examine if serving as a volunteer peer supporter had any effect.

Effects of voluntary attendance patterns on first-year medical students' wellness and academic performance during COVID-19.

There is increasing evidence that attendance is not a reliable predictor of academic performance, which invites the question of whether attendance may have alternative positive effects such as increased student wellness. While conducting an observational cohort study on the relationship of attendance to performance and wellness, the COVID-19 pandemic lockdown changed the ability of students to attend class. Matriculating medical students were recruited to participate at the beginning of their first year in August 2019.

Elimination of Routine Screening Laboratory Tests for Psychiatric Admission: A Quality Improvement Initiative.

Objective: Research has shown that routine screening laboratory tests for patients with mental health symptoms admitted to psychiatry units find little unexpected clinical abnormalities. This study examined the effects on cost of care and patient safety measures of a hospital change in policy in which such routine tests were no longer required.

Methods: This retrospective cohort study analyzed data from all patients admitted from the emergency department (ED) to inpatient psychiatry at a tertiary care hospital 4 months before and 4 months after the policy change.

Intraosseous Pressure Monitoring in Healthy Volunteers.

Study Objective: Invasively monitoring blood pressure through the IO device has not been thoroughly demonstrated. This study attempted to establish baseline values of IO pressure in a healthy human population.

Methods: This was a prospective, healthy volunteer, observational study.

Achieving a Safe Endotracheal Tube Cuff Pressure in the Prehospital Setting: Is It Time to Revise the Standard Cuff Inflation Practice?

Numerous studies have reported unsafe endotracheal tube (ETT) cuff pressures (CP) in the prehospital environment. The purpose of this study was to identify an optimal cuff inflation volume (CIV) to achieve a safe CP (20-30 cmH2O). This observational study utilized 30 recently harvested ovine tracheae, which were warmed from refrigeration in a water bath at 85°F prior to testing.

Demographic, Operational, and Healthcare Utilization Factors Associated with Emergency Department Patient Satisfaction.

Introduction: The primary aim of this study was to determine which objectively-measured patient demographics, emergency department (ED) operational characteristics, and healthcare utilization frequencies (care factors) were associated with patient satisfaction ratings obtained from phone surveys conducted by a third-party vendor for patients discharged from our ED.

Methods: This is a retrospective, observational analysis of data obtained between September 2011 and August 2012 from all English- and Spanish-speaking patients discharged from our ED who were contacted by a third-party patient satisfaction vendor to complete a standardized nine-item telephone survey by a trained phone surveyor. We linked data from completed surveys to the patient's electronic medical record to abstract additional demographic, ED operational, and healthcare utilization data.

The association of health status and providing consent to continued participation in an out-of-hospital cardiac arrest trial performed under exception from informed consent.

Objectives: Emergency medical research performed under federal regulation 21 § CFR 50.24 provides a means to protect human subjects and investigate novel time-sensitive treatments. Although prospective individual consent is not required for studies conducted under this regulation, consent from a legally authorized representative (LAR) or the patient at the earliest feasible opportunity is required to obtain short- and long-term outcome data.

Evaluation of intraosseous pressure in a hypovolemic animal model.

Background: In emergent situations, access to the vascular bed is frequently required for fluid and medication administration. Central venous catheter placement is associated with risk and may slow resuscitation in the unstable patient. The purpose of this study was to determine whether intraosseous pressure (IOP) could be consistently recorded and how similar this pressure was to central venous and arterial pressure in a porcine hemorrhagic shock model.

Prehospital oxygen administration for chest pain patients decreases significantly following implementation of the 2010 AHA guidelines.

Objectives: The purpose of this study was to examine trends in oxygen administration following the 2010 American Heart Association guidelines recommendation to withhold oxygen therapy for patients with uncomplicated presentations of ACS whose SpO2 is 94% or higher.

Methods: Following IRB review and approval, we performed a retrospective analysis of data obtained from Fisdap(TM), a national, clinical skills tracking system for paramedic students between June 2010 and December 2012. Inclusion criteria included: 1) student consent for research, 2) cardiac chest pain recorded as the chief complaint, and 3) SpO2 data available for review.

Magnetic resonance imaging and computed tomography utilization trends in an academic ED.

Objective: The objective of this study is to examine the annual utilization trends of emergency department (ED)-ordered magnetic resonance imaging (MRI) and computed tomography (CT) at an urban academic hospital from 2007 to 2011. We hypothesized that MRI and CT use would increase annually over the study period.

Methods: This was a retrospective observational study of ED encounters between January 1, 2007, and December 31, 2011.

Use of an intraosseous device for invasive pressure monitoring in the ED.

Venous access is essential to providing emergency care for critically ill or injured patients. Obtaining peripheral or central access can be problematic and time consuming. Intraosseous (IO) fluid administration provides similar flow rates and central circulation times compared to central lines, but use of these devices to monitor blood pressure has not been explored.

Does computed tomographic scan affect diagnosis and management of patients with suspected renal colic?

Background: Patients with renal colic commonly present to the emergency department (ED) and are usually treated with analgesics, antiemetics and hydration. Computed tomographic (CT) scan is commonly utilized in evaluating patients with suspected renal colic.

Objectives: We compared diagnosis and treatment plans before and after CT in patients with suspected renal colic with the aim to evaluate how often changes in diagnosis, treatment and disposition are made.

Comparison of success rates between two video laryngoscope systems used in a prehospital clinical trial.

Objectives: The primary aims of this study were to compare paramedic success rates and complications of two different video laryngoscopes in a prehospital clinical study.

Methods: This study was a multi-agency, prospective, non-randomized, cross over clinical trial involving paramedics from four different EMS agencies. Following completion of training sessions, six Storz CMAC™ video laryngoscopes and six King Vision™ (KV) video laryngoscopes were divided between agencies and placed into service for 6 months.

Treatment of non-traumatic out-of-hospital cardiac arrest with active compression decompression cardiopulmonary resuscitation plus an impedance threshold device.

Background: A recent out-of-hospital cardiac arrest (OHCA) clinical trial showed improved survival to hospital discharge (HD) with favorable neurologic function for patients with cardiac arrest of cardiac origin treated with active compression decompression cardiopulmonary resuscitation (CPR) plus an impedance threshold device (ACD+ICD) versus standard (S) CPR. The current analysis examined whether treatment with ACD+ITD is more effective than standard (S-CPR) for all cardiac arrests of non-traumatic origin, regardless of the etiology.

Methods: This is a secondary analysis of data from a randomized, prospective, multicenter, intention-to-treat, OHCA clinical trial.

Supraglottic airway device use as a primary airway during rapid sequence intubation.

Introduction: This study compared first-attempt placement success rates of the King LTS-D as a primary airway for patients requiring medication-assisted airway management (MAAM) against historical controls.

Setting: Rotor-wing division of a single critical care transportation company

Methods: 53 providers (RNs/EMT-P) consented to participation and were trained in the use of the King LTS-D. All patients in need of MAAM per agency treatment guidelines were screened for inclusion and exclusion criteria.

Longitudinal and regional trends in paramedic student exposure to advanced airway placement: 2001-2011.

Objectives: The primary aims of this study were to determine whether the frequency of placement, type of advanced airway, and settings of advanced airway placement (clinical vs. field) have changed for paramedic students over the last 11 years, and to describe regional differences regarding the same set of variables.

Methods: This study was a retrospective review of prospectively reported airway procedures documented by paramedic students in Fisdap ( http://www.

Evaluation of the Storz CMAC®, Glidescope® GVL, AirTraq®, King LTS-D™, and direct laryngoscopy in a simulated difficult airway.

Objective: The aim of this study was to compare first-attempt and overall success rates and success rates in relation to placement time among 5 different airway management devices: Storz CMAC, Glidescope GVL, AirTraq, King LTS-D, and direct laryngoscopy (DL).

Methods: Emergency medical technician basic (EMT-B), EMT-paramedics (EMT-P), and emergency medicine residents and staff physicians placed each of the 5 devices in a random order into an AirSim (TruCorp, Belfast, UK) part-task training manikin. The difficult airway scenario was created by fixing the manikin head to a stationary object and introducing simulated emesis into the hypopharynx.

The emergency department experience with prehospital ketamine: a case series of 13 patients.

Background: There are no published reports examining the effects that ketamine administered prior to hospital arrival has on patients after their transfer to the emergency department (ED).

Objective: In order to better understand the risk-benefit ratio for the prehospital use of ketamine, we examined the ED courses of 13 patients to whom emergency medical services (EMS) had administered ketamine for chemical restraint.

Methods: This project was undertaken as part of our EMS system's continuous quality improvement (CQI) process.

Potential negative effects of epinephrine on carotid blood flow and ETCO2 during active compression-decompression CPR utilizing an impedance threshold device.

Objectives: This study examines the effects of IV epinephrine administration on carotid blood flow (CBF) and end tidal CO(2) (ETCO(2)) production in a swine model of active compression-decompression CPR with an impedance threshold device (ACD-CPR+ITD).

Methods: Six female swine (32 ± 1 kg) were anesthetized, intubated and ventilated. Intracranial, thoracic aorta and right atrial pressures were measured via indwelling catheters.

Comparison of prehospital insertion success rates and time to insertion between standard endotracheal intubation and a supraglottic airway.

Objective: To compare paramedic insertion success rates and time to insertion between standard ETI and a supraglottc airway device (King LTS-D™) in patients needing advanced airway management.

Methods: Between June 2008 and June 2009, consented paramedics from 4 EMS systems performed ETI or placed a King LTS-D according to a predetermined randomization calendar. Data collection occurred following each placement via telephone.

Use of the King LTS-D during medication-assisted airway management.

Objective: This case series evaluated provider use of the King LTS-D as a primary airway in patients requiring rapid-sequence intubation (RSI).

Methods: Twenty-seven paramedics completed a one-hour training session on the use of the device. All patients meeting the service's standard criteria for medication-assisted airway management were included in the study.

Use of the pediatric EZ-IO needle by emergency medical services providers.

Objective: The aim of this study was to examine emergency medical services providers' use of a new intraosseous needle designed for pediatric patients.

Methods: This prospective pilot study was conducted between May 2006 and October 2007. After completing an initial training session, the EZ-IO PD was deployed for use on patients.

Paramedic student adherence to the National Standard Curriculum recommendations.

Objectives: The National Standard Curriculum-Paramedic (NSC-P) is the accepted curriculum for paramedic programs across the country. The purpose of this study was to examine the completion of the NSC-P clinical internship recommendations by paramedic students.

Methods: Paramedic student internship experience data from 2001 to 2005 was retrospectively reviewed from FISDAPtrade mark.

Consecutive field trials using two different intraosseous devices.

Objective: Establishing traditional intravenous (IV) access in adult trauma and medical patients can be difficult. We evaluated provider performance for obtaining intraosseous access with two FDA-approved intraosseous devices (F.A.