Prehospital Care Research Forum Journal Club

Burnout is a growing concern across healthcare, but how deep does it run in EMS, and what's the real cost? In this episode, we explore a national survey of EMS clinicians that uncovers critical insights into well-being, workforce stability, and what might be driving providers away from the profession. Join us to find out how burnout is measured, why it matters more than ever, and what the data reveal about the future of the EMS workforce.

Violence against EMS clinicians is rising—but what if we could see it coming? This month's Journal Club explores Aggressive Behavior Risk Assessment Tool for EMS (ABRAT-EMS), a simple yet powerful 3-item checklist that helps identify potentially violent patients before transport. With strong sensitivity and specificity, this tool could be a game-changer for EMS safety. Tune in as our panel dives into how it works, what it means for frontline providers, and where it fits into broader violence prevention strategies. Article: Aggressive Behavior Risk Assessment Tool for Emergency Medical Services https://www-sciencedirect-com.libproxy.uthscsa.edu/science/article/pii/S2688115225000530

For EMS clinicians, clinical judgment involves higher-order thinking, beginning with clinical reasoning and culminating in clinical decision-making. Existing frameworks suggest that other constructs like leadership and communication may also influence clinical judgment. This evaluation aimed to determine whether leadership and communication are integrated within the broader concept of clinical judgment. Presented Live from Accreditcon 2025. Article: Understanding higher-order constructs of leadership and communication in EMS clinical judgment https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-024-06282-5

This month's PCRF Education Journal Club dives into a systematic review exploring simulation-based education in paramedic training. With clinical placements under pressure, could sim labs be the future—or are we missing something vital? Tune in, read up, and bring your thoughts to the discussion—let's break it down together! Article: Systematic review of the evidence for using simulation to replace clinical practice

In this episode of the Prehospital Care Research Forum's Journal Club, we examine the results of the TRAUMOX2 Randomized Clinical Trial, which compares early restrictive and liberal oxygen strategies for trauma patients. Tune in as we break down the findings, discuss the implications for prehospital and emergency care, and explore how oxygen management could influence outcomes for trauma patients. Don't miss this critical analysis of one of the year's most impactful studies! Article: Early Restrictive vs Liberal Oxygen for Trauma Patients: The TRAUMOX2 Randomized Clinical Trial

How do stress, empathy, and coping strategies impact the clinical competency of paramedic students? In this episode of the education journal club of the Prehospital Care Research Forum Podcast, we delve into the fascinating findings of a study exploring these critical factors in paramedic education. Join us as we uncover how students navigate the pressures of clinical practice, the role of empathy in patient care, and strategies for turning stress into a powerful learning tool.Article: Effects of Clinical Practice Stress, Stress Coping, and Empathy on Clinical Competence among Paramedic Students

In this episode of the Prehospital Care Research Forum's Journal Club, we discuss the findings of a qualitative study examining the acceptability of providing take-home naloxone kits by EMS to individuals at risk of opioid overdose. Discover the insights from the study, including patient perspectives, potential barriers, and the implications for overdose prevention strategies. Join us for a thought-provoking conversation on how EMS can play a pivotal role in combating the opioid crisis.https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2435034?src=

In this episode of the education journal club of the Prehospital Care Research Forum Podcast, we explore the groundbreaking pilot study, "Perceptions and Use of Automated Hospital Outcome Data by EMS Providers." Join us as we dive into the findings on how EMS professionals view and utilize automated hospital outcome data, the challenges of data integration, and its potential to enhance prehospital care. Discover what this research means for bridging the gap between EMS and hospital systems and how it could shape the future of data-driven emergency care. https://escholarship.org/uc/item/24b143f2

In this episode of the Prehospital Care Research Forum's journal club, we take a deep dive into the 2024 Systematic Review of Evidence-Based Guidelines for Prehospital Care. From groundbreaking updates to practical applications, we'll explore how these guidelines are shaping the future of EMS. Join us to learn what's new, what's impactful, and how it all translates to better outcomes in the field. Don't miss this essential episode for EMS professionals striving to stay at the forefront of evidence-based care!https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2412299#abstractPrehospital Guidelines Consortium: https://prehospitalguidelines.orgEMS Research Reading List: https://prehospitalguidelines.org/reading-list/

A new potential treatment for patient agitation and safety intervention for EMS: oral risperidone. While the medication has been around since the early 1990s, it has only recently been used in EMS. Join us for this month's Prehospital Care Research Forum Journal Club as we explore this treatment's feasibility, safety, and potential!https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2361133#

Healthcare students often describe the leap from classroom learning to clinical and field as one of their most challenging transitions. But how can health education better prepare them for the realities of patient care?" In this Prehospital Care Research Forum Educational Journal Club episode, we dive into new research exploring innovative strategies to bridge the gap between theory and practice. Join us as we unpack the findings and implications of this pivotal study, reshaping how medical students are trained for the frontlines of healthcare.https://www.tandfonline.com/doi/full/10.1080/07853890.2024.2443812

Our end-of-year special edition of the PCRF Education Research Journal Club where each of our panelists will share a favorite article from the educational literature in 2024.

There has been no shortage of outstanding EMS clinical research this year! From intramuscular epinephrine injections in cardiac arrest to stabilization of atrial fibrillation in the ambulance, research continues to guide our best patient care practices. Join us for the December Clinical Journal Club as our panelists round out 2024 with an article they think is changing clinical practice in this rapid-fire discussion we are calling The Best of Clinical Research in 2024.

Are virtual patients the future of paramedic training? In our latest episode, we dive deep into the groundbreaking world of 3D Virtual Reality Simulations (3DVRS) and how they stack up against traditional hands-on training. Join us for our next educator Journal Club as we explore a new study comparing these innovative simulations to the real-life experience paramedics rely on. Could VR be the next big thing in emergency medical education? https://onlinelibrary.wiley.com/doi/10.1002/emp2.13092

The administration of Naloxone for patients in cardiac arrest in the out-of-hospital setting has rarely been advised in the United States. Despite this, many EMS agencies allow for its administration and include the opioid antagonist in their cardiac arrest protocols. This contrast leaves the frontline EMT and paramedic with little direction on whether the drug provides a benefit to the patient suffering out-of-hospital cardiac arrest. Join us this month for the Prehospital Care Research Forum's journal club as we revive the topic and review a recent publication that compares out-of-hospital cardiac arrest patients who received Naloxone with those who did not.https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2822449?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamanetworkopen&utm_content=wklyforyou&utm_term=082124&adv=

We have all seen the news articles that ChatGPT and other AI models can pass the MCAT and LSAT. As educators, we worry about computers passing tests, not students. However, is there an opportunity for AI to help us in the classroom, not by taking the test but by writing the explanations for the correct answers? Join us this month for Journal Club, where we will discuss exactly that and review the article: Can ChatGPT generate practice question explanations for medical students, a new faculty teaching tool?https://www.tandfonline.com/doi/full/10.1080/0142159X.2024.2363486

Falls are the leading cause of injury for older Americans; in fact, one out of every four persons aged 65 and older has reported a fall in the past year. Falls are also the leading cause of EMS activations annually, accounting for over 3 million annual ED visits. EMS has a front-row seat in this epidemic, but little has been done to evaluate its role in a cure. In this month's journal club, we review a recent publication that describes the community benefits of an EMS-recognized and evaluated fall prevention program. Article: "Integrating Fall Prevention Strategies into EMS Services to Reduce Falls and Associated Healthcare Costs for Older Adults"https://pubmed.ncbi.nlm.nih.gov/38533419/

AI is already helping to reduce the remedial and redundant tasks in our classroom, but can it design our case studies and simulations, too? Even better, can it increase the diversity of our patient scenarios while removing our preconceived notions and implicit biases? Join us for this month's education journal club as we review research that asked ChatGPT to do precisely that!https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.15977

There is no shortage of advancements in out-of-hospital cardiac arrest. In fact, every time EMS providers renew their CPR or ACLS, changes are made that have been demonstrated to improve the patient's chances of a meaningful recovery. Listen to our discussion on the next potential advancement in out-of-hospital cardiac arrest: intramuscular epinephrine! Article: Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arresthttps://www.resuscitationjournal.com/article/S0300-9572(24)00159-X/fulltext

Can one email from a professor improve students' exam scores? This isn't a story about an accidental email sent with the answer key attached. It is a story about a professor who, using a growth mindset, encourages students to keep pushing forward in their biology class. Join us for this month's education journal club as we explore the impact of faculty mindset on student performance, specifically on first-generation college students, following this experience.https://www.lifescied.org/doi/full/10.1187/cbe.23-07-0131

Workforce shortages continue to pervade EMS. Despite the pandemic recovery and increased efforts at bringing more people into the field and keeping them there, fewer people are choosing to climb into the back of an ambulance. Little work, however, has been put into describing the experience of being an EMT or paramedic, specifically those who are underrepresented in the EMS workforce. Join the Prehospital Care Research Forum clinical journal club this month to explore the latest research on just that, The Female Emergency Medical Services Experience: A Mixed Methods Study.https://www.tandfonline.com/doi/full/10.1080/10903127.2024.2306248

Can you educate healthcare students on delivering life-and-death news to patients, and if so, can you standardize it and evaluate student improvement and performance? Can virtual simulation truly bring the realism necessary to deliver this serious news? Join us for this month's Education Journal Club as we unpack the details of this multi-institutional effort, exploring how virtual simulation is being leveraged to create a scalable, competency-based curriculum.

EMS providers respond to patients suffering from shortness of breath every day and have a vast array of treatment options in the prehospital setting. However, limited analysis describes the nation's EMS treatment of patients suffering from shortness of breath. Join us this month for the PCRF Journal Club to discuss this recent publication describing nationwide trends in the treatment of patients with bronchospasm. Article: Emergency Medical Services Management of Bronchospasm in the United States: A Cross-Sectional Analysis and Nationwide Quality Assessmenthttps://www.tandfonline.com/doi/abs/10.1080/10903127.2023.2220021

Cadaver dissection is one of the highest-rated days of paramedic school for those programs lucky enough to have access to a cadaver lab. However, a fun experience does not always equate to student learning. Join us for this month's educational journal club as we review "A Know-Brainer: The Power of Cadaver-Based Instruction to Teach Clinical Neuroanatomy" and ask whether cadaver dissections help improve learning.

EMS providers are routinely involved in high-stress situations with limited follow-up or healthy coping mechanisms. These experiences can trigger stress responses and burnout in our first-responder community. Despite the widespread conversation about burnout in EMS, limited literature describes the problem. Join us for this month's PCRF Journal Club to review a study that evaluates burnout in EMS using a validated tool.

Live from Accreditcon ! If you have seen one paramedic education program, you have seen one paramedic education program. As educators, we have all heard this mantra when describing the diversity in training modalities utilized by paramedic education programs. However, as reported in the annual Resource Assessment Matrix, there is limited nationwide evaluation of what programs are doing well and where they are falling short. Join the Prehospital Care Research Forum panel and authors this month for a live discussion of Medical Directors, Facilities, and Finances: Resource Deficiencies in Accredited Paramedic Programs. Article: Medical Directors, Facilities, and Finances: Resource Deficiencies in Accredited Paramedic Programs https://www.tandfonline.com/doi/full/10.1080/10903127.2023.2245476?src=recsys

Law enforcement is often the first responder on scene in out of hospital cardiac arrest. The ability for police to provide high quality CPR and early defibrillation can have a substantial impact on patients lives however has rarely been studied. Join us for this month's PCRF Journal Club to discuss this most recent publication that evaluates the impact of law enforcement on patients suffering from out of hospital cardiac arrest

Maintaining skills in pediatric prehospital care is critical since pediatric patient encounters can be high acuity/low frequency. Evidence shows that procedural skills competency decays in as little as three months. These researchers used simulations and first-person video to test the effectiveness of procedural skills training for experienced EMS professionals and its impact on skills retention. Article: Improving Pediatric Procedural Skills for EMS Clinicians: A Longitudinal Simulation-Based Curriculum with Novel, Remote, First-Person-View Video-Based Outcome Measurement.

Did you get out the door in less than 90 seconds? Whether it brings pride or nightmares, this is the most common quality improvement question asked. However, there are other national quality benchmarks for EMS, such as completing a respiratory assessment for patients who are suffering from difficulty breathing and administering medication for patients presenting with a seizure or asthma. Join this month's PCRF Journal Club to discuss this recent publication that evaluates where EMS stacks up on these and other quality benchmarks.

Communication, advocacy, and even history-taking are all behaviors engrained in the EMS provider. In fact, we can all think of an educator, preceptor, or partner who helped teach and role-model these skills. Because these behaviors reflect our training, they are also open to bias based on our different lived experiences. Join us this month for the Prehospital Care Research Forum education podcast as we review this scooping review on using simulation to teach behavioral skills related to diversity, equity, and inclusion.https://pubmed.ncbi.nlm.nih.gov/36194859/

Survival from out of hospital cardiac arrest continues to be a benchmark for EMS Agencies across the globe. Focuses on chest compression quality and early defibrillation have led to substantial improvements in return of spontaneous circulation and thousands more cardiac arrest survivors being able to leave the hospital. Join this month's PCRF Journal Club to discuss a paper that evaluates the size of BVM used and its impact on cardiac arrest survival.

Checklists have become a part of every EMS provider's day. We use them to check in our ambulances, ensure we have all our equipment, and help us prepare for low-frequency skills. However, can a checklist do more than that? Can a checklist help us perform better in the field? Join us for this month's Prehospital Care Research Forum education podcast, where we will review a study that evaluated if using an easy-to-remember checklist can improve cardiac arrest management.

While most cardiac dysrhythmias fit nicely into a treatment algorithm, atrial fibrillation stands out as lacking clear-cut treatment guidelines. Concerns over patient outcome, risk of potential stroke, and further cardiac damage leave many agencies favoring rapid transport and limited treatment. Additionally, limited data is available to link prehospital treatment to the patient's hospital discharge status. Join this month's PCRF Journal Club to discuss a landmark paper that evaluates treating atrial fibrillation in the prehospital setting, including a link between prehospital treatment and hospital outcome data.

Mental health has long been a focus of the overall well-being of the EMS provider. However, should training in stress management start sooner, perhaps during initial education? Can meditation help improve success during paramedic training? To help answer these questions, join this month's Prehospital Care Research Forum education podcast to learn the impacts of adding a course on meditation. Specifically, what benefits were found in reducing depression, anxiety, and stress in initial education paramedic students?

The inherent risk of injury and illness comes with most jobs, more so in the first responder community. Working on the front lines during disasters, roadway collisions, and violent encounters, paramedics experience their fair share of risk. However, limited large-scale data analysis describes the injuries and illnesses paramedics face. Join this month's PCRF Journal Club as we review a study that evaluated workforce data to describe these challenges paramedics face and how we compare to other first responders and those in health care.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10548021/

Join us for this end-of-year special edition of the PCRF Education Research Journal Club when each of our panelists will share a favorite article from the educational literature in 2023.

Most of our pediatric patients cared for and transported by EMS have low acuity, which results in very favorable outcomes. Despite this, EMS providers still experience adverse safety encounters while caring for pediatric patients. Join this month's PCRF Journal Club as we review a study that evaluated the frequency, type, and potential harm from these adverse safety encounters across 15 EMS Agencies in 3 states.

Can students in self-directed endotracheal intubation training accurately and reliably self-evaluate their abilities? This paper used an algorithm-driven hybrid simulation learning method to assess competence. Including peer-to-peer practical skills training. Join us as we explore this method of learning and algorithm for assessment.

In 2012, The National Highway Traffic Safety Administration issued guidelines on the safe transport of pediatric patients to lessen the chance of injury during ambulance transport. However, many EMS clinicians are still unfamiliar with sage transport standards and best practice recommendations in the pediatric population. Join us on the next PCRF Journal Club as we review a study that uses qualitative research methods to explore the range of individual attitudes, organizational policies, and professional norms that may influence choices pertaining to pediatric restraint in ground ambulances. Article: Safe Ground Transport of Pediatric Patients: A Qualitative Assessment of Best Practice Guidelines Implementation https://pubmed.ncbi.nlm.nih.gov/37344226/

EMS providers are uniquely positioned to assess for maltreatment of children and vulnerable populations. Unfortunately, EMS rates of identification and reporting are very low. In this project the authors used an escape room-based format to engage participants on a difficult topic. Join us as we explore this method of teaching and learning. Article: https://pubmed.ncbi.nlm.nih.gov/37318845/

The use of supraglottic airway devices during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients is increasing across the United States and worldwide. The two most commonly used supraglottic airway devices in the United States are the King Laryngeal Tube (King-LT) and the iGel. It is unknown if design differences for the KING-LT and the iGel may translate to differential first pass insertion success or ventilation effectiveness and therefore impact patient outcomes. Join us on the next PCRF Journal Club as we review a study from the CARES surveillance group that compares the neurologic outcomes of OHCA patients managed with the King Laryngeal Tube (King LT) to the neurologic outcomes of patients managed with the iGel. Article: https://pubmed.ncbi.nlm.nih.gov/37120129/

Pediatric patient encounters are infrequent in the EMS setting and can be high risk/high acuity. Augmented reality programs that mix the virtual world with the haptics of a real-world experience, has the potential to augment learning. But is it feasible, usable, and useful in EMS? This study tested one pediatric AR simulation program on a group of EMS professionals to answer that question. Join us LIVE from EMS WORLD EXPO-ISS as we discuss the outcomes of the study, PREHOSPITAL PEDIATRIC EMERGENCY TRAINING USING AUGMENTED REALITY SIMULATION: A PROSPECTIVE, MIXED METHODS STUDY

Pain management is vital to providing comprehensive care to injured children, and the decisions made in the prehospital setting profoundly impact our pediatric patients' overall experience and outcome. However, little is known about how hospital care is impacted by prehospital pain management in pediatric patients.

Where are we with Simulation Based Training (SBT) in EMS? This systematic review of current literature combed through more than 500 studies, identifying common areas of SBT in EMS, high and low fidelity use, and analyzing the setting, strengths, weaknesses and results of each. With shrinking clinical opportunities and increased accountability for competency, is simulation the answer for EMS?

Chest pain is a life-threatening symptom encountered by EMS clinicians every day that demands swift and accurate decision-making to ensure the best possible outcomes. Join us for the next PCRF Journal Club as we review the RESCUE study that delves into the effectiveness of EMS employing chest pain risk stratification tools in prehospital settings and utilizing these tools to assess the severity of chest pain. Listen to find out if these metrics allow for EMS to make informed decisions about the appropriate level of care needed for those suffering from chest pain. Article: https://pubmed.ncbi.nlm.nih.gov/34734787/

Violence against paramedics and other healthcare professionals is an alarming and growing concern in today's society. The rising incidence of violence not only poses significant risks to the well-being of clinicians but also hinders the effective and timely delivery of patient care. Join us for the next PCRF Journal Club as we review a groundbreaking initiative that has been undertaken to evaluate violence against paramedics through a novel, point-of-event reporting process.

The benefits to using ultrasound in EMS continue to grow and are proving to be lifesaving. However there continues to be wide discrepancy of how ultrasound is used, implemented, and taught. Join the Prehospital Care Research Educator Podcast this month as they discuss an air ambulances approach to training their EMS clinicians in the use of ultrasound.

The COVID-19 pandemic has led to significant changes in healthcare practices, including the use of personal protective equipment (PPE) and the adoption of new technologies. One area of focus has been the use of video laryngoscopy for endotracheal intubation, which has been shown to reduce the risk of viral transmission to healthcare workers while also improving the accuracy of intubation. Join the PCRF Journal Club as we review a study that compared the transition from direct laryngoscopy to video laryngoscopy on endotracheal intubation success during the COVID19 Pandemic.

Live from ACCREDITCON! Grab lunch and join the team from Prehospital Care Research Forum for a discussion of current research. The PCRF journal club gathers monthly to discuss current published research affecting all facets of EMS, including topics related to EMS education. During this session, the panel will examine published papers related to accreditation. The role of accreditation in 21st century health professions. education: report of an International Consensus Group https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02121-5 Paramedic educational program attrition accounts for significant loss of potential EMS workforce https://onlinelibrary.wiley.com/doi/10.1002/emp2.12917

One essential goal of EMS education is to promote clinical reasoning. However, assessing student learning in this dimension is challenging. This study describes the adaptation of script concordance testing, a strategy used in other professions, to assess clinical reasoning in paramedic students. Article found here: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-023-04020-x

You arrive on the scene with your EMT partner and are immediately met by the patient and their family, obviously in distress, staring at you for help. As you begin your assessment, you realize you are unable to speak to the patient due to a language barrier. Your mind begins to race for what you can do while you hope someone on scene can help with translation. Every EMS provider has struggled to communicate with his or her patient at some point in an attempt to deliver great patient care. However, little empirical evidence details the barriers to patient care when the provider and patient do not speak the same language. Join the PCRF Journal Club as we review a qualitative study identifying the EMS-perceived barriers to providing patient care for those with limited English proficiency.