Prevalence of Unique Pediatric Pathologies Encountered by Paramedic Students Across Age Groups

Ernest, Eric; Brazelton, Tom; Carhart, Elliot; Studnek, Jonathan R.; Tritt, Patricia L.; Philip, Genghis A.; Burnett, Aaron

doi:10.1017/s1049023x1600056x

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…According to one review of pediatric EMSs calls in the United States, respiratory distress accounted for 11% of ground transports and 9% of air ambulance transports of pediatric patients 1 . Similar findings have been demonstrated by other EMSs agencies in North America 2–4 . An additional study from Southwestern Pennsylvania showed that 6% of pediatric EMSs transports are for asthma 5 …”

mentioning

confidence: 56%

“…1 Similar findings have been demonstrated by other EMSs agencies in North America. [2][3][4] An additional study from Southwestern Pennsylvania showed that 6% of pediatric EMSs transports are for asthma. 5 Given that respiratory disease in pediatric patients is commonly encountered by EMSs, improving the prehospital care for these patients is a natural target for research and quality improvement efforts.…”

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confidence: 99%

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Variation in Prehospital Protocols for Pediatric Respiratory Distress Management in the United States

et al. 2022

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Objective: This study aimed to compare statewide emergency medical services protocols for the management of pediatric respiratory distress. Methods:We performed a descriptive study of emergency medical services protocols for the management of pediatric respiratory distress in the United States, excluding those without model or mandatory protocols. We compared medication recommendations for specific disease processes, including asthma, croup, epiglottitis, anaphylaxis, generalized respiratory distress, intubation, and drug assisted intubation.Results: Thirty-four state protocols were included. All had protocols to address the management of pediatric respiratory distress. There was high agreement in albuterol use for bronchospasm and epinephrine use in anaphylaxis. Epinephrine was recommended in all anaphylaxis protocols, 27 croup protocols (79%), and 3 epiglottitis protocols (9%). Six states (18%) called for albuterol in patients with generalized respiratory distress. Steroid recommendations and indications had variance among states; 26 states (76%) allowed steroid use in patients with asthma, 19 states (56%) recommended steroid use in anaphylaxis, and 11 (32%) recommended steroid use in croup protocols. The route for steroid administration also varied among protocols. Five states (15%) allowed continuous positive airway pressure application in pediatric patients, whereas endotracheal intubation and rapid sequence intubations had varying requirements as well as recommendations for use. Twelve (35%) listed impending or current respiratory failure as an indication, whereas other states had specific markers, such as Glasgow Coma Scale or oxygen saturation, as indications.Conclusions: All included states had specific recommendations for the management of pediatric respiratory distress. There was consistency in recommendations for albuterol use for wheezing and epinephrine use for anaphylaxis. However, there was wide variability in other uses for epinephrine, steroid administration, continuous positive airway pressure use, and specific treatments for croup and epiglottitis. The findings of this study provide a base for important future evidence-based protocol developments and changes in prehospital pediatric respiratory distress treatment.

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confidence: 56%

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confidence: 99%

Variation in Prehospital Protocols for Pediatric Respiratory Distress Management in the United States

et al. 2022

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“…Practically, video game education allows a standardized delivery of content to large numbers of learners asynchronously. Further, video games, unlike human instructors and clinical practice, are not prone to variation in learning content delivery and patient encounters …”

Section: Discussionmentioning

confidence: 99%

60 Seconds to Survival: A Multisite Study of a Screen‐based Simulation to Improve Prehospital Providers Disaster Triage Skills

Cicero

Whitfill

Walsh

et al. 2018

AEM Education and Training

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Objectives: Paramedics and emergency medical technicians (EMTs) perform triage at disaster sites. There is a need for disaster triage training. Live simulation training is costly and difficult to deliver. Screen-based simulations may overcome these training barriers. We hypothesized that a screen-based simulation, 60 Seconds to Survival (60S), would be associated with in-game improvements in triage accuracy.Methods: This was a prospective cohort study of a screen-based simulation intervention, 60S. Participants included emergency medical services (EMS) personnel from 21 EMS agencies across 12 states. Participants performed assessments (e.g., check for pulse) and actions (e.g., reposition the airway) for 12 patients in each scenario and assigned color-coded triage levels (red, yellow, green, or black) to each patient. Participants received on-screen feedback about triage performance immediately after each scenario. A scoring system was designed to encourage accurate and timely triage decisions. Participants who played 60S included practicing EMTs, paramedics, and nurses as well as students studying to assume these roles. Participants played the game at least three times over 13 weeks.Results: In total, 2,234 participants began game play and 739 completed the study and were included in the analysis. Overall, the median number of plays of the game was just above the threshold inclusion criteria (three or more plays) with a median of four plays during the study period (interquartile range [IQR] = 3-7). There was a significant difference in triage accuracy from the first play of the game to the last play of the game. Median baseline triage accuracy in the game was 89.7% (IQR = 82.1%-94.9%), which then increased to a median of 100% at the last game play (IQR = 87.5%-100.0%; p < 0.001). There was some variability in median triage accuracy on fourth through 11th game plays, ranging from 95% to 100%, and on the 12th to 16th plays, the median accuracy was sustained at 100%. There was a significant decrease in the rate of undertriage: from 10.3% (IQR = 5.1%-18.0%) to 0 (IQR = 0%-12.5%; p < 0.001).

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“…student encounters by clinical impression for adolescent, adult, and geriatric patients (ages >12 years). The most common impressions were "other medical" (median encounters per student: 37, IQR: 22-59), trauma (median encounters per student: 33 [16-50]), cardiac (median encounters per student: 30), respiratory (median encounters per student: 23[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]), abdominal pain (median encounters per student 21[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]), and behavioralpsychiatric (median encounters per student: 13[6][7][8][9][10][11][12][13][14][15][16][17][18][19]…”

mentioning

confidence: 99%

Paramedic student encounters with patients during clinical placements: A multi‐institutional cohort study

Page

Brazelton

Kokx³

et al. 2021

JACEP Open

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Prevalence of Unique Pediatric Pathologies Encountered by Paramedic Students Across Age Groups

Cited by 5 publications

References 9 publications

Variation in Prehospital Protocols for Pediatric Respiratory Distress Management in the United States

Variation in Prehospital Protocols for Pediatric Respiratory Distress Management in the United States

60 Seconds to Survival: A Multisite Study of a Screen‐based Simulation to Improve Prehospital Providers Disaster Triage Skills

Paramedic student encounters with patients during clinical placements: A multi‐institutional cohort study

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