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Barriers to Buprenorphine: A Case Series of Misadventures Implementing a Prehospital Buprenorphine Protocol.
Prehosp Emerg Care
January 2025
Prisma Health Department of Emergency Medicine, Greenville, South Carolina.
While several studies have focused on preliminary data and outcomes associated with prehospital buprenorphine administration interventions, to date there has been little discussion of the challenges experienced during the initial implementation of a prehospital buprenorphine protocol. In this case series we examine 3 separate patient encounters with different crews, patients, and receiving emergency medicine (EM) physicians, which highlight initial challenges experienced with implementing the first prehospital buprenorphine program in a rural Appalachian County within South Carolina. In 2 cases we highlight conflicts that may require collegial intervention and education of local receiving EM physicians regarding the new prehospital protocol.
View Article and Find Full Text PDFTime-Critical Emergencies in Suburban Parks and Outdoor Recreation Spaces.
Cureus
December 2024
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
Objective Prior studies have described the patterns of emergency medical service (EMS) activations in national parks in the United States. However, little data exists regarding EMS activations in local and regional outdoor recreational locations. We performed a retrospective analysis of EMS activations originating from parks and recreational areas in suburban Howard County, Maryland, to characterize those activations determined to be time-critical emergencies.
View Article and Find Full Text PDFApproaches, Barriers, and Facilitators in Statewide Initiative to Combat Opioid Overdose: A Narrative Review of Ohio's Experiences During the HEALing Communities Study.
Prehosp Emerg Care
January 2025
Department of Emergency Medicine, MetroHealth Medical Center, Cleveland, Ohio.
Objectives: Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).
View Article and Find Full Text PDFPrehospital Buprenorphine in Treating Symptoms of Opioid Withdrawal - A Descriptive Review of the First 131 Cases in San Francisco, CA.
Prehosp Emerg Care
January 2025
EMS Bridge, Public Health Institute, Oakland, California.
Objectives: Opioid use disorder (OUD) remains a common cause of overdose and mortality in the United States. Emergency medical services (EMS) clinicians often interact with patients with OUD, including during or shortly after an overdose. The aim of this study was to describe the characteristics and outcomes of patients receiving prehospital buprenorphine for the treatment of opioid withdrawal in an urban EMS system.
View Article and Find Full Text PDFOutreach acute care for nursing homes: an observational study on the quality and cost-effectiveness of the Mobile Hospital.
Age Ageing
January 2025
Department of Public Health, University of Helsinki, Helsinki, Uusimaa, Finland.
Background: The global trend of emergency department (ED) crowding can be mitigated with outreach care. The Mobile Hospital is an outreach acute care service in Espoo, Finland. This study describes the results of the Mobile Hospital intervention to nursing homes in a pre-post study setting with benchmarking validation data.
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