Prehospital Identification of Large Vessel Occlusions Using Modified National Institutes of Health Stroke Scale: A Pilot Study.

Stroke identification is a key step in acute ischemic stroke management. Our objectives were to prospectively examine the agreement between prehospital and hospital Modified National Institutes of Health Stroke Scale (mNIHSS) assessments as well as assess the prehospital performance characteristics of the mNIHSS for identification of large vessel occlusion strokes. In this prospective cohort study conducted over a 20-month period (11/2016-6/2018), we trained 40 prehospital providers (paramedics) in Emergency Neurological Life Support (ENLS) curriculum and in mNIHSS.

The accuracy and reliability of an app-based audiometer using consumer headphones: pure tone audiometry in a normal hearing group.

Objective: To undertake a preliminary evaluation of the test-retest reliability, and accuracy of an iPad audiometer app using commercial earphones as a low-cost alternative to a clinical audiometer in a restricted sample of normal hearing participants.

Design: Twenty participants self-reporting normal hearing undertook four pure-tone audiometry tests in a single session. Two tests were performed with a 2-channel Type 1 audiometer (GSI-61) using EAR insert earphones and two tests with an iPad based app (Audiogram Mobile) using Apple earbud headphones.

Paramedic Perspectives on Barriers to Prehospital Acute Stroke Recognition.

Background: Emergency Medical Service (EMS) providers are tasked with rapid evaluation, stabilization, recognition, and transport of acute stroke patients. Although prehospital stroke scales were developed to assist with stroke recognition, unrecognized challenges exist in the prehospital setting that hinder accurate assessment of stroke. The goal of this qualitative study was to systematically understand the challenges and barriers faced by paramedics in recognizing stroke presentations in the field.

Emergency Neurologic Life Support (ENLS): Evolution of Management in the First Hour of a Neurological Emergency.

Emergency neurological life support (ENLS) is an educational program designed to provide users advisory instruction regarding management for the first few hours of a neurological emergency. The content of the course is divided into 14 modules, each addressing a distinct category of neurological injury. The course is appropriate for practitioners and providers from various backgrounds who work in environments of variable medical complexity.

Reviving Freedom House. How the storied ambulance company has been reborn.

Freedom House is our national EMS legacy. It was a revolutionary idea born out of the convergence of political forces. It's our EMS history, but it isn't found in our textbooks.