Simulation-based Assessment of Paramedic Pediatric Resuscitation Skills

Lammers, Richard L.; Byrwa, Maria J; Fales, William; Hale, Robert A.

doi:10.1080/10903120802706161

Cited by 95 publications

(76 citation statements)

References 30 publications

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“…The findings of this study do not negate findings nor diminish the importance of prior studies reporting specifically on medication errors in out-of-hospital medicine, but rather frame them in the context of the lived experiences of EMS professionals. 27,28,29 …”

Section: Discussionmentioning

confidence: 99%

Patient Safety Perceptions in Pediatric Out-of-Hospital Emergency Care: Children's Safety Initiative

Guise

Meckler

OʼBrien

et al. 2015

The Journal of Pediatrics

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Objective To characterize emergency medical service (EMS) providers’ perceptions of the factors that contribute to safety events and errors in the out-of-hospital emergency care of children. Study design We used a Delphi process to achieve consensus in a national sample of 753 emergency medicine physicians and EMS professionals. Convergence and stability were achieved in 3 rounds and findings were reviewed and interpreted by a national expert panel. Results Forty-four (88%) states were represented and 66% of participants were retained through all 3 rounds. From an initial set of 150 potential contributing factors derived from focus groups and literature, participants achieved consensus on the following leading contributors: airway management, heightened anxiety caring for children, lack of pediatric skill proficiency, lack of experience with pediatric equipment, and family members leading to delays or interference with care. Somewhat unexpectedly, medications and communication were low-ranking concerns. After thematic analysis, the overarching domains were ranked by their relative importance: (1) clinical assessment; (2) training; (3) clinical decision-making; (4) equipment; (5) medications; (6) scene characteristics; and (7) EMS cultural norms. Conclusions These findings raise considerations for quality improvement and suggest important roles for pediatricians and pediatric emergency physicians in training, medical oversight, and policy development.

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Section: Discussionmentioning

confidence: 99%

Patient Safety Perceptions in Pediatric Out-of-Hospital Emergency Care: Children's Safety Initiative

Guise

Meckler

OʼBrien

et al. 2015

The Journal of Pediatrics

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“…16 Simulation-based studies have corroborated our results and identified errors in many facets of basic airway and ventilatory management including appropriate application of oxygen, use of oral airways, and bag mask ventilation. 17,18,19 In addition, EMS providers themselves have indicated they feel they would benefit from more pediatric education. 20 …”

Section: Discussionmentioning

confidence: 99%

Children's Safety Initiative: A National Assessment of Pediatric Educational Needs among Emergency Medical Services Providers

Hansen¹,

Meckler²,

Dickinson³

et al. 2014

Prehospital Emergency Care

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Objective Emergency Medical Services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps most likely to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. Methods The Children’s Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care including physicians, nurses and pre-hospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them “highly likely” (likert-type score 7–10 out of 10) to contribute to safety events. Results There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents; EMT-Basics/first responders were 22% and physicians 11.4%. The top educational priorities identified in the final round of the survey include: pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform and advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseos access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. Conclusions This is the first large-scale Delphi survey related to pediatric pre-hospital education. Our results provide foundational information related to the educational needs of pre-hospital providers. Medical directors and educators can use the results to shape future curricular development.

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“…Greater education could involve empiric, diagnostic protocols, simulation of sepsis scenarios, or system-level toolkits. (15,32,33) Similar education interventions were developed in ST-elevation MI and stroke, leading to greater efficiency of out-of-hospital diagnosis and treatment. (33,34) Because nearly 90% of the general public has never heard the term “sepsis,” EMS providers may also play a key role in communication to patients and families.…”

Section: Discussionmentioning

confidence: 99%

Understanding of Sepsis among Emergency Medical Services: A Survey Study

Seymour

Carlbom

Engelberg

et al. 2012

The Journal of Emergency Medicine

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Background Emergency medical services (EMS) personnel commonly encounter sepsis, yet little is known about their understanding of sepsis. Study Objectives To determine the awareness, knowledge, current practice, and attitudes about sepsis among EMS personnel. Methods We performed an anonymous, multi-agency, online survey of emergency medical technicians (EMTs), firefighter-emergency medical technicians (FF-EMTs), and paramedics in a metropolitan, 2-tier EMS system. We compared responses according to the level of EMS training, and used multivariable logistic regression to determine the odds of correctly identifying the definition of sepsis, independent of demographic and professional factors. Results Overall response rate of study participants was 57% (786/1390), and greatest among EMTs (78%; 276/350). A total of 761 respondents (96%) had heard of the term sepsis. EMTs and FF-EMTs were at significantly reduced odds of correctly defining sepsis compared to paramedics, independent of age, sex, and years of experience (EMTs, OR=0.44, 95%CI:0.3,0.8; FF-EMTs, OR=0.32, 95%CI:0.2,0.6,). Overall, knowledge of the clinical signs and symptoms and recommended treatments for sepsis was typically greater than 75%, though best among paramedics than EMTs or FF-EMTs (p<0.01). The majority of respondents believed sepsis is not recognized by EMS “some” or “a lot” of the time (76%, 596/786). Conclusions EMS personnel demonstrated an overall sound awarenessof sepsis. Knowledge of sepsis was less among firefighter-EMTs and EMTs compared to paramedics. These results suggest that paramedics could be integrated into strategies of early identification and treatment of sepsis while EMTs may benefit from focused education and training.

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Simulation-based Assessment of Paramedic Pediatric Resuscitation Skills

Cited by 95 publications

References 30 publications

Patient Safety Perceptions in Pediatric Out-of-Hospital Emergency Care: Children's Safety Initiative

Patient Safety Perceptions in Pediatric Out-of-Hospital Emergency Care: Children's Safety Initiative

Children's Safety Initiative: A National Assessment of Pediatric Educational Needs among Emergency Medical Services Providers

Understanding of Sepsis among Emergency Medical Services: A Survey Study

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