Background: Ambulance offload delay (AOD) has been recognized by the National Association of EMS Physicians (NAEMSP) as an important quality marker. AOD is the time between arrival of a patient by EMS and the time that the EMS crew has given report and moved the patient off of the EMS stretcher, allowing the EMS crew to begin the process of returning to service. The AOD represents a potential delay in patient care and a delay in the availability of an EMS crew and their ambulance for response to emergencies. This pilot study was designed to assess the AOD at a university hospital utilizing direct observation by trained research assistants.
Findings: A convenience sample of 483 patients was observed during a 12-month period. Data were analyzed to determine the AOD overall and for four groups of National Emergency Department Overcrowding Scale (NEDOCS) score ranges. The AOD ranged from 0 min to 157 min with a median of 11 min. When data were grouped by NEDOCS score, there was a statistically significant difference in median AOD between the groups (p < 0.001), indicating the relationship between ED crowding and AOD.
Conclusion: The median AOD was considered significant and raised concerns related to patient care and EMS system resource availability. The NEDOCS score had a positive correlation with AOD and should be further investigated as a potential marker for determining diversion status or for destination decision-making by EMS personnel.
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http://dx.doi.org/10.1186/1865-1380-6-15 | DOI Listing |
Prehosp Emerg Care
January 2025
Emergency Medicine, Methodist Dallas Medical Center, Dallas, Texas.
Non-invasive ventilation has been used as a pre-oxygenation strategy for rapid sequence intubation in the emergency department and the intensive care unit, yet, limited research has examined its use in the transport setting. These case reports discuss the use of non-invasive ventilation via a Hamilton T1 ventilator (Hamilton Medical) during transport by an air medical crew for pre-oxygenation before intubation in two cases. In both cases, a non-invasive, bilevel-positive airway pressure mode with a backup rate was used to achieve adequate airway pressures while allowing for a two-handed seal by one EMS clinician as the other prepared the equipment and medications.
View Article and Find Full Text PDFAddiction
February 2025
DC Fire and EMS Department, Washington, DC, USA.
Background And Aims: Patient initiated transport refusal during Emergency Medical Service (EMS) opioid overdose encounters has become an endemic problem. This study aimed to quantify circumstantial and environmental factors which predict refusal of further care.
Design: In this cross-sectional analysis, a case definition for opioid overdose was applied retrospectively to EMS encounters.
Prehosp Emerg Care
October 2024
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Objectives: To determine the prevalence and associated risk factors of workplace violence (WPV) experienced by emergency medical services (EMS) clinicians across a large, multistate ground/air EMS agency.
Methods: We used a prospective cohort study design from 1 December 2022 to 30 November 2023. A checkbox was added within the electronic medical record (EMR) asking staff to indicate whether WPV occurred.
Prehosp Emerg Care
August 2024
Division of Prehospital Medicine, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Objective: Emergency Medical Services (EMS) clinicians desire performance feedback (PF) and patient outcome follow-up (POF). Within our agency, both a peer-review and feedback/outcome (PF/POF) process exist. Our objective was to determine whether receiving feedback and outcome data improved future clinical care amongst EMS, based upon peer-review scores.
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