Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Sayed, Mazen El; Tamim, Hani; Mann, N. Clay

doi:10.1017/s1049023x1600008x

Cited by 7 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the recent civilian-based study on MASCAL events by El Sayed et al, the most common medications administered were oxygen and intravenous (IV) fluids; this is compared to the military-combat setting in the present study wherein the most common intervention was hemorrhage control. The current dataset had smaller proportion of patients receiving IV fluid than the civilian data by El Sayed et al (3.7% versus 6.9%) 3 . Another study by El Sayed et al found that the most common prehospital interventions performed were spine immobilization (21.8%) and IV access (14.1%) 4 .…”

Section: Discussioncontrasting

confidence: 50%

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

Schauer

April

Simon

et al. 2017

Prehosp. Disaster med.

View full text Add to dashboard Cite

The most common prehospital interventions were tourniquet and pressure dressing hemorrhage control, along with pain medication administration. Larger data sets are needed to guide development of MASCAL in-theater clinical practice guidelines. Schauer SG , April MD , Simon E , Maddry JK , Carter R III , Delorenzo RA . Prehospital interventions during mass-casualty events in Afghanistan: a case analysis. Prehosp Disaster Med. 2017;32(4):465-468.

show abstract

Section: Discussioncontrasting

confidence: 50%

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

Schauer

April

Simon

et al. 2017

Prehosp. Disaster med.

View full text Add to dashboard Cite

show abstract

“…[12] Participating States have different inclusion criteria and proportions of submitted EMS activations. [13,14] Each EMS record in NEMSIS corresponds to a unique activation submitted by a single responding vehicle. Thus, if multiple EMS vehicles respond to the same event, multiple records for the same event will reside in the national database.…”

Section: Methodsmentioning

confidence: 99%

Impact of prehospital mechanical ventilation

Sayed¹,

Tamim

Mailhac³

et al. 2019

Medicine

Self Cite

View full text Add to dashboard Cite

Prehospital use of ventilators by emergency medical services (EMS) during 911 calls is increasing. This study described the impact of prehospital mechanical ventilation on prehospital time intervals and on mortality.This retrospective matched-cohort study used 4 consecutive public releases of the US National Emergency Medical Services Information System dataset (2011–2014). EMS activations with recorded ventilator use were randomly matched with activations without ventilator use (1 to 1) on age (range ± 2 years), gender, provider's primary impression, urbanicity, and level of service.A total of 5740 EMS activations were included (2870 patients per group). Patients in the ventilator group had a mean age of 69.1 (±17.3) years with 49.4% males, similar to the non-ventilator group. Activations were mostly in urban settings (83.8%) with an advanced life support level of care (94.5%). Respiratory distress (77.8%) and cardiac arrest (6.8%) were the most common provider's primary impressions. Continuous positive airway pressure was the most common mode of ventilation used (79.2%).Mortality was higher at hospital discharge (29.0% vs 21.1%, P = .01) but not at emergency department (ED) discharge (8.4% vs 7.4%, P = .19) with prehospital ventilator use. Both total on-scene time and total prehospital time intervals increased with reported ventilator use (4.10 minutes (95% confidence interval [CI]: 2.71–5.49) and 3.59 minutes (95% CI: 3.04–4.14), respectively).Ventilator use by EMS agencies in 911 calls in the US is associated with higher prehospital time intervals without observed impact on survival to ED discharge. More EMS outcome research is needed to provide evidence-based prehospital care guidelines and targeted resource utilization.

show abstract

“…Standardized definitions in the NEMSIS manual were used; TASER use is reported under procedures performed to the patient as “Wound Care - TASER Barb Removal.” 26 Additional variables that were analyzed included EMS agency information such as: EMS service area urbanicity (population setting using United States Department of Agriculture [USDA; Washington, DC USA] and Office of Management and Budget [OMB; Washington, DC USA] definitions) 27 – 29 and reported Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) service level (mainly Basic Life Support [BLS; BLS and BLS emergency] and Advanced Life Support [ALS; ALS Level 1, Level 1 emergency, and Level 2]), in addition to primary role of unit, incident location type, response mode to scene, and transport mode from scene.…”

Section: Methodsmentioning

confidence: 99%

“…26 Submission rates and inclusion criteria vary by state. [26][27][28][29] Every record in the database represents a single EMS activation that is submitted by a single responding vehicle. Thus, the NEMSIS database represents a collection of EMS activations for emergency care rather than a collection of unique patients.…”

Section: Study Settingmentioning

confidence: 99%

See 1 more Smart Citation

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study

Sayed

Tawil

Tamim

et al. 2018

Prehosp. Disaster med.

Self Cite

View full text Add to dashboard Cite

BackgroundConducted electrical weapons (CEWs), including Thomas A. Swift Electric Rifles (TASERs), are increasingly used by law enforcement officers (LEOs) in the US and world-wide. Little is known about the experience of Emergency Medical Service (EMS) providers with these incidents.ObjectivesThis study describes EMS encounters with documented TASER use and barb removal, characteristics of resulting injuries, and treatment provided.MethodsThis retrospective study used five combined, consecutive National Emergency Medical Services Information System (NEMSIS; Salt Lake City, Utah USA) public-release datasets (2011-2015). All EMS activations with documented TASER barb removal were included. Descriptive analyses were carried out.ResultsThe study included 648 EMS activations with documented TASER barb removal, yielding a prevalence rate of 4.55 per 1,000,000 EMS activations. Patients had a mean age of 35.9 years (SD=18.2). The majority were males (80.2%) and mainly white (71.3%). Included EMS activations were mostly in urban or suburban areas (78.3%). Over one-half received Advanced Life Support (ALS)-level of service (58.2%). The most common chief complaint reported by dispatch were burns (29.9%), followed by traumatic injury (16.1%). Patients had pain (45.6%) or wound (17.2%) as a primary symptom, with most having possible injury (77.8%). Reported causes of injury were mainly fire and flames (29.8%) or excessive heat (16.7%). The provider’s primary impressions were traumatic injury (66.3%) and behavioral/psychiatric disorder (16.8%). Only one cardiac arrest (0.2%) was reported. Over one-half of activations resulted in patient transports (56.3%), mainly to a hospital (91.2%). These encounters required routine EMS care (procedures and medications). An increase in the prevalence of EMS activations with documented TASER barb removal over the study period was not significant (P=.27).ConclusionAt present, EMS activations with documented TASER barb removal are rare. Routine care by EMS is expected, and life-threatening emergencies are not common. All EMS providers should be familiar with local policies and procedures related to TASER use and barb removal.El SayedM, El TawilC, TamimH, MailhacA, MannNC. Emergency Medical Services experience with barb removal after TASER use by law enforcement: a descriptive national study. Prehosp Disaster Med. 2019;34(1):38–45.

show abstract

Description of Medication Administration by Emergency Medical Services during Mass-casualty Incidents in the United States

Abstract: Medications are administered frequently in MCIs, mainly Oxygen, crystalloids, and narcotic pain medications. Emergency Medical Services systems can use the findings of this study to better prepare their stockpiles for MCIs.

Cited by 7 publications

References 8 publications

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

Prehospital Interventions During Mass-Casualty Events in Afghanistan: A Case Analysis

Impact of prehospital mechanical ventilation

Emergency Medical Services Experience With Barb Removal After Taser Use By Law Enforcement: A Descriptive National Study

Contact Info

Product

Resources

About