Background And Aims: Prehospital critical care for out-of-hospital cardiac arrest (OHCA) is a complex and largely unproven intervention. During research to examine this intervention, we noted significant differences in stakeholders' views about research, randomisation, and the funding of prehospital critical care for OHCA. We aimed to answer the following questions: What are stakeholders' priorities for prehospital research? What are stakeholders' views on randomisation of prehospital critical care? How do stakeholders consider allocation of resources in prehospital care?
Methods: We undertook an explanatory qualitative framework analysis of interviews and focus group with 5 key stakeholder groups: patients and public, air ambulance charities, ambulance service commissioners, prehospital researchers, and prehospital critical care providers.
Results: We undertook 3 focus group discussions with a total of 23 participants and 8 interviews with a total of 9 participants. Despite sharing a common appreciation of the concepts of scientific enquiry, fairness, and beneficence, the 5 relevant stakeholder groups displayed divergent views of research and funding strategies regarding the intervention of prehospital critical care for the condition of OHCA. The reasons for this divergence could largely be explained through the different personal experiences and situational contexts of each stakeholder group. Many aspects of the strategies suggested by the stakeholder groups only partially aligned with principles of traditional evidence-based medicine, but were held with strong conviction.
Discussion: Analysis of the views of 5 stakeholder groups regarding research and the funding of prehospital critical care for OHCA revealed shared values but a variety of different strategies to achieve these. This knowledge can help researchers in similar fields in the planning and presentation of their research, to maximise impact on decision making.
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http://dx.doi.org/10.1002/hsr2.78 | DOI Listing |
Heart Lung
January 2025
Sakarya University, Faculty of Medicine, Department of Emergency, Sakarya, Türkiye. Electronic address:
Background: While clinical indicators for synchronized cardioversion in regular supraventricular tachycardias are well-established, their application by prehospital emergency medical services (EMS) still needs to be explored.
Objective: The purpose of this study was to evaluate the factors influencing the decision-making process of prehospital EMS personnel to perform synchronized cardioversion in adults with narrow QRS regular tachyarrhythmias.
Methods: This descriptive study included 598 paramedics actively engaged in prehospital EMS.
Mil Med
January 2025
Combat Paramedic Program, U.S. Army MedCoE, JBSA Fort Sam Houston, TX 78234, USA.
The combat medic (68W) will play a critical role in medical operations in the event of future large-scale combat operations (LSCOs). However, the combat medic is largely not prepared for LSCOs. The revised Medical Education and Demonstration of Individual Competence (TC 8-800) state 68Ws much be able to provide advanced airway and trauma management, medication administration, and advanced casualty movement.
View Article and Find Full Text PDFAm J Emerg Med
January 2025
Faculty of Medicine, Universidad de Valladolid, Valladolid, Spain; Emergency Department, Hospital Clínico Universitario, Gerencia Regional de Salud de Castilla y León, Valladolid, Spain.
Background: The study of the inclusion of new variables in already existing early warning scores is a growing field. The aim of this work was to determine how capnometry measurements, in the form of end-tidal CO2 (ETCO2) and the perfusion index (PI), could improve the National Early Warning Score (NEWS2).
Methods: A secondary, prospective, multicenter, cohort study was undertaken in adult patients with unselected acute diseases who needed continuous monitoring in the emergency department (ED), involving two tertiary hospitals in Spain from October 1, 2022, to June 30, 2023.
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 PDFBurns
December 2024
Trauma Nova Scotia, Nova Scotia Health, Halifax, NS B3H 2Y9, Canada. Electronic address:
Introduction: The combination of burns and non-thermal trauma may have a synergistic effect on mortality. Our objective was to determine if burn patients with concomitant trauma are at increased risk of mortality in both the prehospital and in-hospital settings.
Methods: Data were collected from a population-based provincial trauma registry (2001-2019).
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