Prehospital Airway Management Training and Education: An NAEMSP Position Statement and Resource Document.

AbstractAirway management competency extends beyond technical skills to encompass a comprehensive approach to optimize patient outcomes. Initial and continuing education for airway management must therefore extend beyond a narrow focus on psychomotor skills and task completion to include appreciation of underlying pathophysiology, clinical judgment, and higher-order decision making. NAEMSP recommends:Active engagement in deliberate practice should be the guiding approach for developing and maintaining competence in airway management.EMS learners and clinicians must be educated in an escalating approach to airway management, where basic airway maneuvers form the central focus.Educational activities should extend beyond fundamental knowledge to focus on the development of clinical judgment.Optimization of patient outcomes should be valued over performance of individual airway management skills.Credentialing and continuing education activities in airway management are essential to advance clinicians beyond entry-level competency.Initial and continuing education programs should be responsive to advances in the evidence base and maintain adaptability to re-assess content and expected outcomes on a continual basis.

EMS Curriculum Should Educate Beyond a Technical Scope of Practice: Position Statement and Resource Document.

Position Statement and Resource document approved by the NAEMSP Board of Directors on April 27, 2021.

Determining a Need for Point-of-Care Ultrasound in Helicopter Emergency Medical Services Transport.

OBJECTIVE: Point-of care-ultrasound (PoCUS) is useful in evaluating unstable emergency department patients. The portability of this technology increases its potential use in prehospital settings, including helicopter emergency medical services (HEMS) programs. Identifying useful applications may support implementing a PoCUS program that develops sonography skills for prehospital providers. The aim of this study was to determine the HEMS patient population that would benefit from prehospital PoCUS for hypotension and how commonly the extended focused assessment with sonography in trauma (E-FAST) for trauma patients or the rapid ultrasound in shock (RUSH) for medical patients could be used by HEMS. METHODS: A retrospective chart review was performed over a 1-year period of adult patients transported by a midwestern HEMS system. Charts were reviewed for episodes of hypotension. RESULTS: The chart review included 216 charts, of which 3 were excluded. Of the 213 cases, 100 were trauma patients, and 113 were medical patients. Of the trauma patients, 51% experienced hypotension, as did 73 of 113 medical patients. CONCLUSION: Fifty percent of HEMS patients may benefit from PoCUS to evaluate for hypotension in flight.

Documenting Patient Interaction: Emergency Medical Services Report Reader Expectations and Improvements for Providers.

INTRODUCTION: Patient care reports contain critical elements related to interventions rendered and medical decision-making. Yet, little consensus exists around reader expectations, leaving emergency medical services (EMS) providers unaware of critical content. OBJECTIVES: This 2-phase study aimed to answer the questions "What do EMS providers know about report readers?" and "What do report readers expect from reports?" through surveys and interviews. In doing so, this study gauged EMS providers' audience awareness of report readership and determined what readers expected from reports. METHODS: A prospective survey was conducted with 57 EMS providers to gauge their level of audience awareness or how often they thought of specific report reader groups when writing reports. Interviews were conducted with 14 report readers following retrospective think-aloud protocol, where participants verbalized their questions, comments, and concerns about reports while reading. RESULTS: Surveys indicate participants lacked a full, accurate sense of audience awareness. When writing reports, they thought of audiences, such as patients, who do not regularly read reports, while reporting not thinking of actual report readers-such as billing specialists-often or at all. Interview analysis indicated that report readers looked for 21 elements in high-quality, effective report narratives. CONCLUSIONS: These data formalize and reinforce what a high-quality narrative should include, with "high-quality" meaning the narrative allows readers to do their jobs without follow-up or an amendment needed to the report.

ED EMS time: A COVID-friendly alternative to ambulance ride-alongs.

BACKGROUND: Ambulance ride-alongs are frequently a critical element of educational programs for learners of prehospital emergency care. We describe a novel alternative to the EMS ride-along experience more conducive to COVID-19 restrictions. METHODS: "ED EMS time" was developed as an alternative training method to provide a field-type experience within the emergency department (ED) setting. Over the course of a 4-h shift, medical students observe and complete standardized reflections on online medical control radio consultations and EMS-to-ED patient handoffs. Medical students also interview EMS clinicians to gain insight into prehospital care and the challenges that occur in the field. Experiences are debriefed with an EMS attending. RESULTS: Medical students expressed increased knowledge around the challenges and treatment capabilities of EMS through the ED EMS time experience. They were able to explain what information obtained from the scene was helpful to EMS clinicians. Medical students were able to realize the objectives of ambulance ride time through an ED experience designed around EMS. CONCLUSIONS: ED EMS time represents a novel approach to teaching medical students the intricacies of prehospital medicine from the confines of the ED while avoiding direct patient contact, preserving PPE, and limiting COVID-19 exposure.