Sepsis alerts in EMS and the results of pre-hospital ETCO2.

Background: Field sepsis alerts have the ability to expedite initial ED sepsis treatment. Our hypothesis is that in patients that meet EMS sepsis alert criteria there is a strong relationship between prehospital end-tidal carbon dioxide (ETCO2) readings and the outcome of diagnosed infection.

Methods: In 2014, our EMS service initiated a protocol requiring hospitals to receive notification of a "sepsis alert" on all suspected sepsis patients.

Ondansetron oral dissolving tablets are superior to normal saline alone for prehospital nausea.

Background: Antiemetics have been shown to be effective in multiple hospital settings, but few studies have been done in the prehospital environment.

Objectives: Our hypotheses were 1) that the amount of normal saline administered during an emergency medical services (EMS) transport was not related to a change in nausea and vomiting and 2) that the addition of the ondansetron orally disintegrating tablet (ODT) would decrease the degree of nausea.

Methods: This was a pre-post study of two cohorts of consecutive patients with nausea in the prehospital setting.

The use of chemical restraints reduces agitation in patients transported by emergency medical services.

Background: Agitated patients are the primary source of injury to patients and providers during ambulance transport.

Objective: Our primary hypothesis was that the addition of a chemical restraint agent (midazolam) to a restraint protocol would reduce agitation to a greater extent than a restraint protocol with physical restraint alone.

Methods: The local emergency medical services restraint protocol (RP) was implemented on October 1, 2006.

Computer-aided diagnosis with potential application to rapid detection of disease outbreaks.

Our objectives are to quickly interpret symptoms of emergency patients to identify likely syndromes and to improve population-wide disease outbreak detection. We constructed a database of 248 syndromes, each syndrome having an estimated probability of producing any of 85 symptoms, with some two-way, three-way, and five-way probabilities reflecting correlations among symptoms. Using these multi-way probabilities in conjunction with an iterative proportional fitting algorithm allows estimation of full conditional probabilities.