Defining the Core Content for Transport Physician Training Programs.

In many parts of the world, emergency medical services (EMS) clinical care is traditionally delivered by different levels or types of EMS clinicians, such as emergency medical technicians and paramedics. In some areas, physicians are also included among the cadre of professionals administering EMS-based care. This is especially true in the interfacility transport (IFT) setting.

Interfacility Transport of Mechanically Ventilated Patients with Suspected COVID-19 in the Prone Position.

Objective: Prone positioning during mechanical ventilation in patients with severe respiratory failure is an important intervention with both physiologic and empiric rationale for its use. This study describes a consecutive cohort of patients with severe hypoxemic respiratory failure due to COVID-19 who were transported in the prone position in order to determine the incidence of serious adverse events (SAEs) during transport.

Methods: This retrospective study used prospectively collected data from a provincial air and land critical care transport system where specially trained critical care paramedic crews transported intubated and mechanically ventilated patients with COVID-19 in the prone position.

A Dedicated SARS-CoV-2 Testing Center for Public Service Agency Personnel: Implementation, Results, and Impact on Human Resources.

A global pandemic due to an emerging infectious disease requires efficient use of resources to ensure continued operation of essential services. To mitigate risk to these services and the population served, there needs to be a rapid identification of infected personnel via screening and testing. This retrospective study used prospectively collected data from a dedicated SARS-CoV-2 testing center for fire, police, and paramedic personnel in Toronto, Canada to determine the incidence of seropositive personnel and their immediate household, and estimate the days off work saved by timely access to testing and results.

Pretransport Risk Assessment of Agitated Patients in Air Medical Transport.

Objective: To determine the ability for a simple pretransport mental health risk assessment tool for patients who are agitated or experiencing an acute psychiatric illness to predict in-transit disruptive behavior necessitating additional intervention(s) while being transported via air ambulance.

Methods: We conducted this retrospective cohort study using existing data from the provincial air and land critical care transport system (Ornge) in Ontario, Canada, from April 2019 until March 2020. A total of 498 cases were included in this study.

Toward an all-inclusive trauma system in Central South Ontario: development of the Trauma-System Performance Improvement and Knowledge Exchange (T-SPIKE) project.

Background: There is currently no integrated data system to capture the true burden of injury and its management within Ontario's regional trauma networks (RTNs), largely owing to difficulties in identifying these patients across the multiple health care provider records. Our project represents an iterative effort to create the ability to chart the course of care for all injured patients within the Central South RTN.

Methods: Through broad stakeholder engagement of major health care provider organizations within the Central South RTN, we obtained research ethics board approval and established data-sharing agreements with multiple agencies.

Blood product transfusion during air medical transport: A needs assessment.

Objectives: Early administration of blood products to patients with hemorrhagic shock has a positive impact on morbidity and mortality. Smaller hospitals may have limited supply of blood, and air medical systems may not carry blood. The primary outcome is to quantify the number of patients meeting established physiologic criteria for blood product administration and to identify which patients receive and which ones do not receive it due to lack of availability locally.

Air medical transport myths.

The role of air medical and land-based critical care transport services is not always clear amongst traditional emergency medical service providers or hospital-based health care practitioners. Some of this is historical, when air medical services were in their infancy and their role within the broader health care system was limited. Despite their evolution within the regionalized health care system, some myths remain regarding air medical services in Canada.

Paediatric health care access in community health centres is associated with survival for critically ill children who undergo inter-facility transport: A province-wide observational study.

Background: Diverse settlement makes inter-facility transport of critically ill children a necessary part of regionalized health care. There are few studies of outcomes and health care services use of this growing population.

Methods: A retrospective study evaluated the frequency of transports, health care services use, and outcomes of all critically ill children who underwent inter-facility transport to a paediatric intensive care unit (PICU) in Ontario from 2004 to 2012.

Evaluation of pain management in medical transfer of trauma patients by air.

Objectives: With regionalized trauma care, medical transport times can be prolonged, requiring paramedics to manage patient care and symptoms. Our objective was to evaluate pain management during air transport of trauma patients.

Methods: We conducted a 12-month review of electronic paramedic records from a provincial critical care transport agency.