emergency medical technicians
Summary: Paramedical personnel trained to provide basic emergency care and life support under the supervision of physicians and/or nurses. These services may be carried out at the site of the emergency, in the ambulance, or in a health care institution.
- Batchelder A, Steel A, Mackenzie R, Hormis A, Daniels T, Holding N. Simulation as a tool to improve the safety of pre-hospital anaesthesia--a pilot study. Anaesthesia. 2009;64:978-83 pubmed publisher..0 (0-1.8 [0-2]) vs 3.5 (1.5-4.8 [0-8], respectively; p = 0.011). Crew resource management behaviours also improved in later simulations. On a personal training needs analysis, participants reported increased confidence after the course. ..
- Halpern J, Maunder R, Schwartz B, Gurevich M. Identifying risk of emotional sequelae after critical incidents. Emerg Med J. 2011;28:51-6 pubmed publisher..Four easily identifiable responses to a critical incident can potentially be used for early self-identification of risk of later emotional difficulties. These findings should be submitted to prospective testing. ..
- Donnelly E, Siebert D. Occupational risk factors in the emergency medical services. Prehosp Disaster Med. 2009;24:422-9 pubmedDuring a medical emergency, the American public often relies on the expertise of emergency medical technicians (EMTs)...
- Smith R, Conn A. Prehospital care - scoop and run or stay and play?. Injury. 2009;40 Suppl 4:S23-6 pubmed publisher..There may be more need for advanced techniques in the rural environment or where transport times are prolonged and certainly a need for more studies into subsets of patients who may benefit from interventions in the field. ..
- Kim C, Shin S, Song K, Park C. Diagnostic accuracy of focused assessment with sonography for trauma (FAST) examinations performed by emergency medical technicians. Prehosp Emerg Care. 2012;16:400-6 pubmed publisher..diagnostic accuracy of focused assessment with sonography for trauma (FAST) examinations when used by emergency medical technicians (EMTs) to detect the presence of free abdominal fluid...
- Gentzler M, Stader S. Posture stress on firefighters and emergency medical technicians (EMTs) associated with repetitive reaching, bending, lifting, and pulling tasks. Work. 2010;37:227-39 pubmed publisher..The participants were firefighters and emergency medical technicians (EMTs) in an urban U.S. fire department...
- Frascone R, Russi C, Lick C, Conterato M, Wewerka S, Griffith K, et al. Comparison of prehospital insertion success rates and time to insertion between standard endotracheal intubation and a supraglottic airway. Resuscitation. 2011;82:1529-36 pubmed publisher..5s vs. King LTS-D=20.0s; z=-0.25; p=0.80). In this study, no differences in placement success rate or time to insertion were detected between the King LTS-D and ETI. ..
- Rahmani A, Hassankhani H, Mills J, Dadashzadeh A. Exposure of Iranian emergency medical technicians to workplace violence: a cross-sectional analysis. Emerg Med Australas. 2012;24:105-10 pubmed publisherb>Emergency medical technicians (EMTs) in Iran experience concerning levels of workplace violence, although until now there has been no investigation of this phenomenon...
- Revicki D, Gershon R. Work-related stress and psychological distress in emergency medical technicians. J Occup Health Psychol. 1996;1:391-6 pubmedb>Emergency medical technicians (N = 65) participated in a study on work environment characteristics, work-related stress, and psychological distress. Data were collected at baseline and 6 months...
- Sterud T, Ekeberg Ø, Hem E. Health status in the ambulance services: a systematic review. BMC Health Serv Res. 2006;6:82 pubmed..More coordinated research and replication are needed to compare data across studies. We discuss some strategies for future research. ..
- Aasa U, Brulin C, Angquist K, Barnekow Bergkvist M. Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel. Scand J Caring Sci. 2005;19:251-8 pubmed..Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel. ..
- Okada N, Ishii N, Nakata M, Nakayama S. Occupational stress among Japanese emergency medical technicians: Hyogo Prefecture. Prehosp Disaster Med. 2005;20:115-21 pubmed..Although job satisfaction among paramedics was high, they were exposed to greater mental stress. Therefore, systematic management of stress must be developed and established. ..
- Lord B, Parsell B. Measurement of pain in the prehospital setting using a visual analogue scale. Prehosp Disaster Med. 2003;18:353-8 pubmed..Regular audits form part of clinical quality assurance programs that assess analgesic practice. However, such audits must have access to data obtained from patient self-reporting of pain using a valid and reliable pain measurement tool. ..
- Crystal R, Bleetman A, Steyn R. Ambulance crew assessment of trauma severity and alerting practice for trauma patients brought to a general hospital. Resuscitation. 2004;60:279-82 pubmed..Pre-hospital trauma severity assessment needs developing with appropriate ambulance protocols, to ensure appropriate alert calls. ..
- Davis D, Dunford J, Poste J, Ochs M, Holbrook T, Fortlage D, et al. The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients. J Trauma. 2004;57:1-8; discussion 8-10 pubmed..51; 95% confidence interval, 1.33-4.72; p = 0.004). Hyperventilation and severe hypoxia during paramedic RSI are associated with an increase in mortality. ..
- Saver J, Kidwell C, Eckstein M, Starkman S. Prehospital neuroprotective therapy for acute stroke: results of the Field Administration of Stroke Therapy-Magnesium (FAST-MAG) pilot trial. Stroke. 2004;35:e106-8 pubmed..Field initiation of Mg sulfate in acute stroke patients is feasible and safe. Prehospital trial conduct substantially reduces on-scene to needle time and permits hyperacute delivery of neuroprotective therapy. ..
- Garner A, Rashford S, Lee A, Bartolacci R. Addition of physicians to paramedic helicopter services decreases blunt trauma mortality. Aust N Z J Surg. 1999;69:697-701 pubmed..This results in significantly lower mortality. Critical care physicians should be added to paramedic helicopter services for scene response to blunt trauma. ..
- Waeckerle J, Seamans S, Whiteside M, Pons P, White S, Burstein J, et al. Executive summary: developing objectives, content, and competencies for the training of emergency medical technicians, emergency physicians, and emergency nurses to care for casualties resulting from nuclear, biological, or chemical incidents. Ann Emerg Med. 2001;37:587-601 pubmed..Furthermore, the task force recommends incorporating NBC training into standard training programs for emergency medical professionals. ..
- Mechem C, Dickinson E, Shofer F, Jaslow D. Injuries from assaults on paramedics and firefighters in an urban emergency medical services system. Prehosp Emerg Care. 2002;6:396-401 pubmed..In this EMS system, injuries resulting from assaults were uncommon. However, due to their potential impact on the victims and the EMS system as a whole, policies and procedures should be developed to minimize these incidents. ..
- Osterwalder J. Mortality of blunt polytrauma: a comparison between emergency physicians and emergency medical technicians--prospective cohort study at a level I hospital in eastern Switzerland. J Trauma. 2003;55:355-61 pubmed..was to establish whether the prehospital deployment of emergency physicians (EPs) rather than emergency medical technicians (EMTs) decreased mortality in blunt polytrauma patients...
- Sayre M, Sakles J, Mistler A, Evans J, Kramer A, Pancioli A. Field trial of endotracheal intubation by basic EMTs. Ann Emerg Med. 1998;31:228-33 pubmed..This low intubation success rate calls into question the validity of the endotracheal-intubation training module in the 1994 EMT-B national curriculum. ..
- Young K, Cooper C. Change in stress outcomes following an industrial dispute in the ambulance service: a longitudinal study. Health Serv Manage Res. 1999;12:51-62 pubmed..It is proposed that the manner in which the aftermath of the dispute and ensuing organizational change were managed gave an increasingly limited scope for influence. ..
- Rischitelli G, Harris J, McCauley L, Gershon R, Guidotti T. The risk of acquiring hepatitis B or C among public safety workers: a systematic review. Am J Prev Med. 2001;20:299-306 pubmed..Other public safety workers appear to have lower rates of exposure. Urban areas have much higher prevalence of disease, and public safety workers in those areas are likely to experience a higher incidence of exposure events. ..
- Brillhart A, Rea T, Becker L, Eisenberg M, Murray J. Time to first shock by emergency medical technicians with automated external defibrillators. Prehosp Emerg Care. 2002;6:373-7 pubmed..0, 95% confidence interval = 2.1, 47.5). The findings suggest that a 1-minute goal and a 90-second minimum standard for time to first shock are appropriate for EMT AED defibrillation in the field. ..
- Jonsson A, Segesten K, Mattsson B. Post-traumatic stress among Swedish ambulance personnel. Emerg Med J. 2003;20:79-84 pubmed..This study presents a better understanding between post-traumatic stress and underlying factors among ambulance personnel. ..
- Kaye K, Frascone R, Held T. Prehospital rapid-sequence intubation: a pilot training program. Prehosp Emerg Care. 2003;7:235-40 pubmed..Limitations of this model include the availability of live animal labs and the expense of conducting the training. Intense medical director involvement has been key to the success of this prehospital RSI program. ..
- Wharton N, Gibbison B, Gabbott D, Haslam G, Muchatuta N, Cook T. I-gel insertion by novices in manikins and patients. Anaesthesia. 2008;63:991-5 pubmed publisher..Further work determining safety and efficacy during cardiopulmonary resuscitation is required. ..
- Bobrow B, Clark L, Ewy G, Chikani V, Sanders A, Berg R, et al. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA. 2008;299:1158-65 pubmed publisher..4; 95% CI, 2.0-5.8). Survival-to-hospital discharge of patients with out-of-hospital cardiac arrest increased after implementation of MICR as an alternate EMS protocol. These results need to be confirmed in a randomized trial. ..
- Liberman M, Roudsari B. Prehospital trauma care: what do we really know?. Curr Opin Crit Care. 2007;13:691-6 pubmed..There is no convincing evidence that prehospital advanced life support in the urban setting provides any benefit to injured patients in terms of either morbidity or mortality. ..
- Roudsari B, Nathens A, Cameron P, Civil I, Gruen R, Koepsell T, et al. International comparison of prehospital trauma care systems. Injury. 2007;38:993-1000 pubmed..The reasons for these findings deserve further studies. ..
- Mason S, Knowles E, Colwell B, Dixon S, Wardrope J, Gorringe R, et al. Effectiveness of paramedic practitioners in attending 999 calls from elderly people in the community: cluster randomised controlled trial. BMJ. 2007;335:919 pubmed..ISRCTN27796329 [controlled-trials.com]. ..
- Bobrow B, Demaerschalk B, Wood J, Montgomery C, Clark L. Assessment of emergency medical technicians serving the Phoenix metropolitan matrix of primary stroke centers. Stroke. 2007;38:e25 pubmed
- Davis D, Valentine C, Ochs M, Vilke G, Hoyt D. The Combitube as a salvage airway device for paramedic rapid sequence intubation. Ann Emerg Med. 2003;42:697-704 pubmed..The device should be tested in other sizes and types of systems and under less medical scrutiny than was used in this study. ..
- Wang H, Lave J, Sirio C, Yealy D. Paramedic intubation errors: isolated events or symptoms of larger problems?. Health Aff (Millwood). 2006;25:501-9 pubmed..These findings indicate frequent errors associated with this life-saving technique. These events might be emblematic of larger issues in the structure and delivery of out-of-hospital emergency care. ..
- Crill M, Hostler D. Back strength and flexibility of EMS providers in practicing prehospital providers. J Occup Rehabil. 2005;15:105-11 pubmed..This group of professionals may be at risk for occupational injury and should be targeted for interventions to improve strength and flexibility. ..
- Boal W, Hales T, Ross C. Blood-borne pathogens among firefighters and emergency medical technicians. Prehosp Emerg Care. 2005;9:236-47 pubmed..surveys of exposures to blood or surveillance of blood-borne infections among firefighters and/or emergency medical technicians (EMTs) in the United States were reviewed...
- Hobgood C, Xie J, Weiner B, Hooker J. Error identification, disclosure, and reporting: practice patterns of three emergency medicine provider types. Acad Emerg Med. 2004;11:196-9 pubmed..Provider-specific education and enhanced teamwork training will be required to further the transformation of the ED into a high-reliability organization. ..
- Wik L, Kramer Johansen J, Myklebust H, Sørebø H, Svensson L, Fellows B, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005;293:299-304 pubmed..Electrocardiographic analysis and defibrillation accounted for only small parts of intervals without chest compressions. ..
- Schmidt T, Zechnich A, Doherty M. Oregon emergency medical technicians' attitudes toward physician-assisted suicide. Acad Emerg Med. 1998;5:912-8 pubmedTo determine Oregon intermediate and advanced emergency medical technicians' (EMTs') attitudes toward physician-assisted suicide (PAS) and factors associated with those attitudes...
- Liberman M, Lavoie A, Mulder D, Sampalis J. Cardiopulmonary resuscitation: errors made by pre-hospital emergency medical personnel. Resuscitation. 1999;42:47-55 pubmed..purpose of the current study was to evaluate the CPR techniques of emergency healthcare professionals (emergency medical technicians, firemen, emergency first responders, CPR instructors)...
- Alexander D, Klein S. Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. Br J Psychiatry. 2001;178:76-81 pubmed..Concerns about confidentiality and career prospects deter staff from seeking personal help. The mental health and emotional well-being of ambulance personnel appear to be compromised by accident and emergency work. ..
- Markenson D, Reilly M, DiMaggio C. Public health department training of emergency medical technicians for bioterrorism and public health emergencies: results of a national assessment. J Public Health Manag Pract. 2005;Suppl:S68-74 pubmed..74, 95% CI = 2.68, 2.81). Local and state public health agencies should work with the emergency medical services systems to develop and deliver training with an all-hazards approach to disasters and other public health emergencies. ..
- Lefrançois D, Dufour D. Use of the esophageal tracheal combitube by basic emergency medical technicians. Resuscitation. 2002;52:77-83 pubmed..Our results suggest that EMT-Ds can use the ETC for control of the airway and ventilation in cardiorespiratory arrest patients safely and effectively. ..
- Verbeek P, Vermeulen M, Ali F, Messenger D, Summers J, Morrison L. Derivation of a termination-of-resuscitation guideline for emergency medical technicians using automated external defibrillators. Acad Emerg Med. 2002;9:671-8 pubmed..arrest and survival to hospital discharge following failed resuscitation by defibrillation-trained emergency medical technicians (EMT-Ds), and to propose an out-of-hospital termination-of-resuscitation (TOR) guideline for EMT-Ds...
- Kurola J, Turunen M, Laakso J, Gorski J, Paakkonen H, Silfvast T. A comparison of the laryngeal tube and bag-valve mask ventilation by emergency medical technicians: a feasibility study in anesthetized patients. Anesth Analg. 2005;101:1477-81 pubmed..In this study, we found that inexperienced fire-EMT students inserted LT and performed 1-min ventilation with a reasonable success rate and insertion time in anesthetized patients. ..
- Maguire B, Hunting K, Guidotti T, Smith G. Occupational injuries among emergency medical services personnel. Prehosp Emerg Care. 2005;9:405-11 pubmed..Funding and additional research are critical to further defining the high risks to EMS workers and developing interventions to mitigate this serious problem. ..
- Maguire B, Hunting K, Smith G, Levick N. Occupational fatalities in emergency medical services: a hidden crisis. Ann Emerg Med. 2002;40:625-32 pubmed..0 during the same time period. This study identifies an occupational fatality rate for EMS workers that exceeds that of the general population and is comparable with that of other emergency public service workers. ..
- Ball L. Setting the scene for the paramedic in primary care: a review of the literature. Emerg Med J. 2005;22:896-900 pubmed..However, in the longer term, and more importantly, paramedics must learn to work together to take ownership of the basic philosophies of their practice, which must have their foundation in valid and reliable research. ..
- Duchateau F, Bajolet Laplante M, Chollet C, Ricard Hibon A, Marty J. [Exposure of French emergency medical personnel to violence]. Ann Fr Anesth Reanim. 2002;21:775-8 pubmed..Only 9% (24/270) had a formal training for management of violence. Formal training in the management of violent encounters and prevention of post-traumatic stress should be developed. ..
- Garvey J, MacLeod B, Sopko G, Hand M. Pre-hospital 12-lead electrocardiography programs: a call for implementation by emergency medical services systems providing advanced life support--National Heart Attack Alert Program (NHAAP) Coordinating Committee; National Heart, Lung, and Blood In. J Am Coll Cardiol. 2006;47:485-91 pubmed
- van der Ploeg E, Kleber R. Acute and chronic job stressors among ambulance personnel: predictors of health symptoms. Occup Environ Med. 2003;60 Suppl 1:i40-6 pubmed..When implementing workplace interventions these social aspects need to be taken into account. ..
- Arreola Risa C, Vargas J, Contreras I, Mock C. Effect of emergency medical technician certification for all prehospital personnel in a Latin American city. J Trauma. 2007;63:914-9 pubmed..These data support the promotion of policies that require and enable EMT certification for all prehospital care providers in Mexico and potentially also in other Latin American and other middle-income developing countries. ..