Development Of Guidelines Research Articles

What do health professionals think about implementing psilocybin-assisted therapy in palliative care for existential distress? A World Café qualitative study.

Promising studies show that psilocybin-assisted therapy relieves existential distress in patients with serious illnesses, a difficult condition to treat with current treatment options. There is growing interest in this therapy in palliative care. Canada recently amended its laws to allow physicians to request psilocybin for end-of-life distress. However, barriers to access remain. Since implementing psilocybin-assisted therapy within palliative care depends on the attitudes of healthcare providers willing to recommend it, they should be actively engaged in the broader discussion about this treatment option. We aimed (1) to identify issues and concerns regarding the acceptability of this therapy among palliative care professionals and to discuss ways of remedying them and (2) to identify factors that may facilitate access. A qualitative study design and World Café methodology were adopted to collect data. The event was held on April 24, 2023, with 16 palliative care professionals. The data was analyzed following an inductive approach. Although participants were interested in psilocybin-assisted therapy, several concerns and needs were identified. Educational and certified training needs, medical legalization of psilocybin, more research, refinement of therapy protocols, reflections on the type of professionals dispensing the therapy, the treatment venue, and eligibility criteria for treatment were discussed. Palliative care professionals consider psilocybin-assisted therapy a treatment of interest, but it generates several concerns. According to our results, the acceptability of the therapy and the expansion of its access seem interrelated. The development of guidelines will be essential to encourage wider therapy deployment.

An optimal set of criteria for the allocation of territories within the Arctic zone of the Russian Federation

The article examines the criteria for classifying regions in the Far North as part of the Arctic Zone within the Russian Federation. It evaluates a range of factors, including natural and climatic conditions, socio-economic aspects, and the medical and biological characteristics of the territories. Additionally, the article presents the outcomes of zoning the northern territories of the Russian Federation based on the natural and climatic conditions that impact human life. This analysis resulted in the identification of three criteria for determining the inclusion of territories in the Arctic Zone of the Russian Federation: the vegetation component of landscapes in its zonal distribution; the CAFF boundary, which proposed by the Arctic Council’s Arctic Flora and Fauna Conservation Working Group; and the level of ultraviolet deficiency, which reflects the direct impact of latitude on the natural environment and human health. These criteria are characterized by their clarity and ease of interpretation, and do not require the development or endorsement of supplementary methodological guidelines. They are easily grasped by both regional leaders and residents regarding the inclusion or exclusion of areas from the Arctic Zone of the Russian Federation. Consequently, these criteria can be effectively integrated into federal legislation as directly applicable norms.

Learner training for phonetic transcription of typical and/or disordered speech: A scoping review.

Phonetic transcription is a core skill of speech and language therapists/pathologists (SLT/Ps) for clinical assessment of speech sounds and/or errors, and linguists for investigation of phonetic phenomena in various languages; hence, it is included in the curriculum of the corresponding degree programme. Many experts and course instructors have discussed their opinions on different aspects of phonetic transcription teaching and/or reported their own training programmes. However, no review has systematically summarized the types of expert recommendations and training methodology reported in the literature. Such information is important for mapping the knowledge gaps, refining current teaching and planning further research. To systematically summarize (1) the materials and procedures for delivering and evaluating phonetic transcription training programmes, and (2) the opinions from experts in phonetic transcription teaching regarding but not limited to the content, rationale(s), format and structure, and timing of teaching phonetic transcription of typical speech and/or disordered speech reported in the literature. A scoping review was carried out by following the Joanna Briggs Institute methodology. PubMed, EBSCOhost and Web of Science were searched and citation searching of included papers was completed. The included papers were divided into training programme reports, of which data (e.g., type and number of speech stimuli used, type and number of learners, outcome measures) were charted, and expert opinion papers, analysed using content analysis. A total of 565 studies were retrieved. After excluding duplicates and irrelevant papers and merging two sources that reported the same training, a total of 23 sources on training programmes and six opinion papers were analysed. Most training were for English and for SLT/P students, with some for the linguistics students. There are variations in the training content (with phonetic transcription practice as the main procedure), delivery mode (some presented via websites or computer software), stimuli (audio recordings of typical adults and children with speech disorders were most used), feedback (mostly immediate feedback using answer keys) and outcome measures (mainly transcription accuracy of learners and user opinions). Content analysis of opinion papers determined five main categories: rationale for training; aspects of the delivery of training; transcription; problem areas noted; and strategies/resources. Implications and considerations for teaching are discussed, along with recommendations for research in the design of evidence-based training. The findings can contribute to the development of general guidelines about phonetic transcription training in educational programmes and the establishment of pre-registration competencies. What is already known on this subject Phonetic transcription is a core skill of SLT/Ps and linguists for clinical speech assessment and research, and it is an important component in the curriculum of the relevant degree programmes. Many experts and course instructors have discussed their opinions regarding phonetic transcription teaching and/or reported their own training programmes in various sources such as books and book chapters, research papers and conference proceedings. What this paper adds to the existing knowledge The paper reports a scoping review that systematically summarized the materials and procedures for delivering and evaluating phonetic transcription programmes and experts' opinions and recommendations for phonetic transcription teaching, reported in the literature. The data from these two types of sources allowed an integrated discussion of the various aspects of phonetic transcription training, such as content, format and structure, materials and timing of teaching and the evaluation of training efficacy. What are the potential or actual clinical implications of this work? The data synthesized and discussed provide a foundation for a review of current practice in phonetic transcription teaching in SLT education. The findings can contribute to the development of general guidelines about phonetic transcription training in educational programmes and the establishment of pre-registration competencies.

Survey of the endoscopy workforce’s perception of sustainability

ObjectiveThe National Health Service is a significant contributor to greenhouse gas emissions, with endoscopy ranking as the third highest contributor of waste in healthcare. We aimed to ascertain the endoscopy...

Guidelines Within And For Public Health Services: Results Of An Online Survey On Current Practical Needs

Evidence-based guidelines are recognized and well-established in everyday medical practice. However, in the Public Health Service (PHS), evidence-based guidelines are not yet widely available. To promote the development of guidelines within and for the ÖGD, the Federal Joint Committee (GBA) issued a funding directive in June 2024. This study presents the results of an online survey on the prioritization of guideline topics in the ÖGD, conducted by the German Society for Public Health Services (DGÖG). The survey focused on 17 guideline topics proposed by the GBA, which were divided into six task areas. Out of over 900 participants, comprehensive responses from nearly 500 respondents were analyzed, 85% of whom work in local health departments. The results showed that all 17 guideline topics were assigned high or very high priority. Particularly frequently prioritized were the areas of infection hygiene monitoring, medical expert assessment, and psychosocial emergency care. Additionally, experts highlighted dental screening, health literacy on oral health, and monitoring of drinking and bathing water. The qualitative analysis further identified additional relevant topics, including health reporting and planning, health promotion and prevention, child welfare, as well as crisis management and communication. The survey provides insights into the priority topics for guidelines as perceived by practitioners and ÖGD researchers. The results underscore the significant need for evidence-based guidelines in and for the ÖGD and provide valuable insights for further development and prioritization.

National recommendations for the management of children and young people with IgA vasculitis: a best available evidence, group agreement-based approach

ObjectiveIgA vasculitis (IgAV) is the most frequently experienced subtype of vasculitis seen in children. Most children fully recover, however, complications including chronic kidney disease are recognised. The aim of this...

Integrating deep phenotyping with genetic analysis: a comprehensive workflow for diagnosis and management of rare bone diseases.

Phenotypes play a fundamental role in medical genetics, serving as external manifestations of underlying genotypes. Deep phenotyping, a cornerstone of precision medicine, involves precise multi-system phenotype assessments, facilitating disease subtyping and genetic understanding. Despite their significance, the field lacks standardized protocols for accurate phenotype evaluation, hindering clinical comprehension and research comparability. We present a comprehensive workflow of deep phenotyping for rare bone diseases from the Genetics Clinic of Skeletal Deformity at Peking Union Medical College Hospital. Our workflow integrates referral, informed consent, and detailed phenotype evaluation through HPO standards, capturing nuanced phenotypic characteristics using clinical examinations, questionnaires, and multimedia documentation. Genetic testing and counseling follow, based on deep phenotyping results, ensuring personalized interventions. Multidisciplinary team consultations facilitate comprehensive patient care and clinical guideline development. Regular follow-up visits emphasize dynamic phenotype reassessment, ensuring treatment strategies remain responsive to evolving patient needs. In conclusion, this study highlights the importance of deep phenotyping in rare bone diseases, offering a standardized framework for phenotype evaluation, genetic analysis, and multidisciplinary intervention. By enhancing clinical care and research outcomes, this approach contributes to the advancement of precision medicine in the field of medical genetics.

Integrating ethics in public health guideline development: a case-study of the NTCA guidelines on respiratory isolation for persons with TB in community settings.

Public health interventions often involve explicit tradeoffs in which the health of the many must be weighed against burdens imposed on individuals. We describe development of public health guidelines for respiratory isolation in community settings for persons with tuberculosis. While stopping the spread of disease is a core moral imperative in public health, the duty to prevent disease transmission does not supersede all other considerations. Community wellbeing must be balanced with individual wellbeing, liberty, and social justice. In response to these challenges, the National TB Coalition of America's (NTCA) 2024 Guidelines for persons with tuberculosis in community settings were developed using a modified GRADE approach supported by a complementary, comprehensive, and context-specific ethical framework. By addressing the distinct roles that evidence (subject to uncertainty), values, justificatory conditions, and procedural legitimacy all play in ethical guideline development, we promote rigor and transparency in the integration of ethics in public health guidelines.

Implementation of a Clinical Decision Support System for Antimicrobial Prescribing in Sub-Saharan Africa: Multisectoral Qualitative Study.

Suboptimal use of antimicrobials is a driver of antimicrobial resistance in West Africa. Clinical decision support systems (CDSSs) can facilitate access to updated and reliable recommendations. This study aimed to assess contextual factors that could facilitate the implementation of a CDSS for antimicrobial prescribing in West Africa and Central Africa and to identify tailored implementation strategies. This qualitative study was conducted through 21 semistructured individual interviews via videoconference with health care professionals between September and December 2020. Participants were recruited using purposive sampling in a transnational capacity-building network for hospital preparedness in West Africa. The interview guide included multiple constructs derived from the Consolidated Framework for Implementation Research. Interviews were transcribed, and data were analyzed using thematic analysis. The panel of participants included health practitioners (12/21, 57%), health actors trained in engineering (2/21, 10%), project managers (3/21, 14%), antimicrobial resistance research experts (2/21, 10%), a clinical microbiologist (1/21, 5%), and an anthropologist (1/21, 5%). Contextual factors influencing the implementation of eHealth tools existed at the individual, health care system, and national levels. At the individual level, the main challenge was to design a user-centered CDSS adapted to the prescriber's clinical routine and structural constraints. Most of the participants stated that the CDSS should not only target physicians in academic hospitals who can use their network to disseminate the tool but also general practitioners, primary care nurses, midwives, and other health care workers who are the main prescribers of antimicrobials in rural areas of West Africa. The heterogeneity in antimicrobial prescribing training among prescribers was a significant challenge to the use of a common CDSS. At the country level, weak pharmaceutical regulations, the lack of official guidelines for antimicrobial prescribing, limited access to clinical microbiology laboratories, self-medication, and disparity in health care coverage lead to inappropriate antimicrobial use and could limit the implementation and diffusion of CDSS for antimicrobial prescribing. Participants emphasized the importance of building a solid eHealth ecosystem in their countries by establishing academic partnerships, developing physician networks, and involving diverse stakeholders to address challenges. Additional implementation strategies included conducting a local needs assessment, identifying early adopters, promoting network weaving, using implementation advisers, and creating a learning collaborative. Participants noted that a CDSS for antimicrobial prescribing could be a powerful tool for the development and dissemination of official guidelines for infectious diseases in West Africa. These results suggest that a CDSS for antimicrobial prescribing adapted for nonspecialized prescribers could have a role in improving clinical decisions. They also confirm the relevance of adopting a cross-disciplinary approach with participants from different backgrounds to assess contextual factors, including social, political, and economic determinants.

Malaysian occupational therapists’ perspectives on sensory-based intervention for children with autism spectrum disorder: A focus group discussion

ABSTRACT This study explores Malaysian occupational therapists’ perspectives on implementing sensory-based intervention for children with autism spectrum disorder, addressing the high prevalence of sensory processing disorder in this population. Despite sensory-based intervention’s common usage globally, its implementation and associated challenges remain inadequately documented. The research employed a qualitative approach, conducting two focus group discussions with 14 experienced occupational therapists. Thematic analysis using ATLAS.ti software revealed eight themes: intervention approaches, implementation references, common activities, implementation structure, strategies, intervention types, evaluation methods, and challenges encountered. The findings emphasize the importance of personalized intervention strategies to meet the diverse sensory needs of children with autism spectrum disorder. The study highlights the necessity for developing comprehensive guidelines for effective sensory-based intervention implementation and underscores the need for individualized approaches. The study’s findings provide a contextual overview of sensory-based intervention in addressing sensory processing disorder among children with autism spectrum disorder. This research may inform the development of evidence-based guidelines and protocols for sensory interventions in occupational therapy practice, ultimately improving the quality of care for children with autism spectrum disorder.

A pragmatic approach to selecting a grading system for clinical practice recommendations in palliative care.

The limited palliative care evidence base is poorly amenable to existing grading schemes utilized in guidelines. Many recommendations are based on expert consensus or clinical practice standards, which are often considered 'low-quality' evidence. Reinforcing provider hesitancy in translating recommendations to practice has implications for patient care. To rationalize the selection of an appropriate grading system for rating evidence to support recommendations made in palliative care clinical practice guidelines. Review of the methodology sections of international palliative care guidelines published in English identified five grading systems comparison: Grading of Recommendations, Assessment, Development and Evaluations (GRADE); the Scottish Intercollegiate Guidelines Network (SIGN); Infectious Diseases Society of America-European Society for Medical Oncology (IDSA-ESMO); Confidence in the Evidence from Reviews of Qualitative research (CERQual) and the National Service Framework for Long Term Conditions (NSF-LTC). There is heterogeneity among grading systems used in published palliative care or terminal symptom management guidelines. GRADE has been increasingly adopted for its methodological rigour and inter-guideline consistency with other medical associations. CERQual has the potential to support recommendations informed by qualitative evidence, but its role in clinical guidelines is less defined. The IDSA-ESMO system has an intuitive typology with the ability to categorize tiers of lower-quality evidence. It is challenging to apply commonly used grading systems to the palliative care evidence base, which often lacks robust randomized controlled trials (RCTs). Adoption of IDSA-ESMO offers a feasible and practical alternative for lower-resourced guideline developers and palliative clinicians without a prerequisite for methodological expertise.

Physiological responses, ethology, and ingestive behavior of Anglo-Nubiana goats submitted to different air temperatures

The objective of this study was to evaluate the physiological parameters and ingestive behavior of Anglo-Nubian goats as a function of air temperature, as well as the correlation of these variables. Six male goats were distributed in a completely randomized design in a climate chamber. The treatments consisted of four different controlled AT (20, 24, 28 and 32 °C). The physiological responses: heart rate (HR), respiratory rate (RR) and rectal temperature (RT) were collected at three different times of the day (8 am, 12 pm and 4 pm). The behavioral responses evaluated were: lying inactive, standing inactive, feeding, standing ruminating and lying ruminating. The feed intake decreased linearly in the hours of 4–7 AM, according to the increase in AT. The time spent in the lying ruminating activity decreased linearly (P<0.05) with the increase in AT. The intake and the rate of dry matter intake decreased linearly (P<0.05) with the increase in AT and the water intake increased linearly (P<0.05). The overall results provide information that can be used in heat tolerance studies, helping livestock farmers around the world to plan and make decisions. In addition to contributing to the development of strategies, national and international guidelines for mitigation and accurate assessment of thermal stress.

Increased myositis and possible myocarditis in melanoma patients treated with immune checkpoint inhibitors in the COVID-19 era.

Immune checkpoint inhibitor (ICI)-mediated myocarditis results in significant morbidity and mortality. At our institution, we noted an increased incidence of ICI-mediated myocarditis cases, leading to further investigation in our database of advanced melanoma patients treated with ICI therapy. A single-center, retrospective cohort analysis of patients with advanced melanoma identified cases of ICI-mediated myocarditis and myositis. 366 patients with advanced melanoma received a dose of ICI from September 2014 to October 2019. Of these patients, there were 0 cases of ICI-mediated myocarditis (0%, 95% CI 0%-1.0%) and 2 cases of ICI-mediated myositis (0.55%, 95% CI 0.07%-1.96%). From November 2019 to December 2021, an additional 246 patients with advanced melanoma were identified. Of these patients, 10 (4.1%, 95% CI 1.97%-7.35%) developed ICI-mediated myocarditis and 10 developed ICI-mediated myositis. Our study suggests an increase in prevalence of ICI-mediated muscle damage including myositis and myocarditis in the COVID-19 era. Differentiation of these patients and further risk stratification may allow for development of guidelines for nuanced management of this serious complication.

Seismic vulnerability assessment and fragility analysis of tunnels in Oman: Development of risk matrices and functionality guidelines

Past seismic events worldwide inflicted severe damage on tunneling and underground infrastructure projects and resulted in considerable socioeconomic loss. In this study, the seismic vulnerability of tunnels in the Sultanate of Oman is assessed, accounting for tunnel typology and localized site conditions. Seismic Fragility Curves (SFCs) were developed for two seismic zones (Zone 1 and Zone 2) based on the proposed intensity-response relationship, incorporating two different lining properties. Results consistently indicated a 39.56 % decrease in raking ratio for every 15 m/s reduction in shear wave velocity (VSST) across all tunnel models, spanning soft to stiff strata conditions. Employing the fragility functions developed for the Sultanate of Oman, project-specific risk matrices and operational route maps for Al-Sharqiyah Expressway Tunnel-2 (AST2) were formulated, along with an assessment of post-seismic operational accessibility. The insights garnered from this investigation provide fundamental guidance for engineers, designers, and consultants involved in seismic analysis and design of underground structures, encompassing both new constructions and retrofitting endeavors. Furthermore, the data generated herein offers valuable input for governmental stakeholders, facilitating policy formulation and the establishment of national-level design directives concerning tunneling projects within the Sultanate of Oman.

Investigation of the vibro-acoustic signature of a heat pump through an experimental transfer path analysis

With the increasing interest on heat pumps due to their energy efficiency and environmentally favorable characteristics, concerns regarding their operational noise and vibration levels are becoming paramount, particularly in residential applications where occupant comfort is a priority. A heat pump consists of significantly distinct components regarding their physical properties, contributing to a complex dynamic system with respect to noise and vibration. To better understand its vibro-acoustic signature, this work presents an experimental transfer path analysis (TPA) of an outdoor unit of a heat pump system for residential applications. In this study, the main noise sources and the predominant vibration and noise paths are identified. Predictions of the total and partial responses at the receiver side is determined in order to quantify the contribution of each individual path. For the determination of the operational internal forces, the inversion matrix method is adopted. The findings of this study can contribute to the development of effective design guidelines and engineering solutions for minimizing the acoustic and vibrational footprint of residential heat pumps.

Pre-procedural Topical Antisepsis in the Neonate: A Systematic Review Evaluating Risk Factors for Skin Injury.

Pre-procedural antisepsis is a critical component of hospital-acquired infection prevention in the neonatal intensive care unit (NICU). However, broadly utilized topical antiseptic agents pose an elevated risk of disruption to neonatal skin integrity, and evidence-based guidelines are lacking. This systematic review of the literature sought to assess and characterize the predisposing risk factors for and types of neonatal skin injury from topical antiseptic agents. A systematic search of Medline Ovid, Embase, Web of Science, CINAHL, and Cochrane Library was conducted, including academic literature providing data on neonatal skin injuries related to topical antisepsis in the NICU. A total of 19 articles (99 patients) met the inclusion criteria. Of the available data, most reported skin injuries were described in extremely preterm (98.1%) and very low birth weight (98.4%) infants. The majority of reported adverse cutaneous events were attributed to chlorhexidine preparations (74.8%), followed by octenidine (18.2%), povidone-iodine (6.1%), and isopropyl alcohol (2.0%). Erythema (40.1%), skin breakdown (23.4%), and chemical burns (17.5%) were the skin reactions reported most frequently, followed by skin irritation (8.3%), and skin necrosis (2.8%). Our findings indicate that both extremely preterm and very low birth weight infants are particularly susceptible to skin toxicities from pre-procedural antiseptic preparations. These data underscore the need for future research to support the development of guidelines which minimize iatrogenic cutaneous injuries in the neonatal population, specifically for the care of infants under 2 months of age, for whom current recommendations are lacking due to a paucity of data.

A preliminary analysis of long-term self-reported sleep disturbance attributed to wind turbines and modelled outdoor nightly average wind turbine sound pressure level

The World Health Organization (WHO) Environmental Noise Guidelines provide source-based annual average nighttime sound pressure level (Lnight) recommendations. For non-aircraft sources the recommendation for self-reported high sleep disturbance (HSD) is the Lnight associated with an absolute prevalence of 3%HSD. The Guideline Development Group (GDG) reported that no Lnight recommendation could be provided for wind turbines because the evidence available was inadequate. In the current study, outdoor wind turbine Lnight at each dwelling was calculated following international standards. Questionnaires were completed between May and September 2013 by individuals aged 18-79y (606 males, 632 females), randomly selected from households 0.25 to 11.22 kilometers from operational wind turbines. Calculated Lnight ranged from &lt;25 dB(A) to 46 dB(A). When the source of sleep disturbance was unspecified, the mean prevalence of HSD was 13.3% overall and unrelated to Lnight (p = 0.53). As Lnight increased, the prevalence of identifying wind turbines as one of the causes of sleep disturbance increased from 0% below 25 dB(A) to 3.8% (95% CI 1.9% to 7.4%) between 40-46 dB(A) (p = 0.01) . The WHO's 3%HSD threshold was estimated to occur for wind turbine Lnight between 38-39 dB(A).

Indian consensus statements on the management of small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

No pan-India-specific guidelines exist for the management of urological cancers. Although western guidelines are useful for informing management strategies, they do not account for the nuances of management in the Indian context. A modified Delphi method was used to provide a framework for the systematic development of India-centric guidelines for the management of three uro-oncology disease states: small renal masses, non-muscle invasive bladder cancer and high-risk/locally advanced prostate cancer.

The Egyptian 24-h movement guidelines for children and adolescents: an integration of physical activity, sedentary behaviour, sleep and eating habits—by the Egyptian Academy of Bone and Muscle health

BackgroundThe objectives of this work were as follows: (1) to develop holistic recommendations for physical activity, sleep, sedentary behaviours and eating habits adapted to children and adolescent life stage (5–17 years) and targeting optimal metabolic cycle and achieving energy balance; (2) to provide evidence-based information that can be used by the government, policy makers, healthcare professionals, community, schools as well as families to endorse active, healthy, living in apparently healthy children and youth aged 5–17 years, and as a base for monitoring the activities, particularly the physical ones, on the people level. The Egyptian Academy of Bone and Muscle Health followed an established guideline development process to create the Egyptian 24-h movement clinical guideline for children and adolescents. Online databases (PubMed, Embase and Cochrane Library) were searched for relevant peer-reviewed studies that met the a priori inclusion criteria.ResultsA total of 41 studies met the inclusion criteria. Leveraging evidence from the review of the literature led to the development of 11 key questions covering 8 domains. Fifteen statements focus on the overall identified targets through integration of the movement activities and eating behaviour. Results revealed a major change in the previous basic understandings as it shifts away from segregated into integrated movement behaviour and dietary habit paradigm. Based on this, the final guideline was developed providing evidence-based recommendations for a “Healthy 24-h day”, for Egyptian children and adolescents.ConclusionThe 24-h composition of movement behaviours has principal implications for health at all ages. The developed guideline provides an up-to-date evidence-based recommendation towards a holistic approach for favourable daily life activities and adopts a feasible perspective by outlining these activities within a 24-h period. In addition, eating and dietary elements have been included to complete the energy cycle. Children and adolescents who meet the 24-h movement guidelines generally report more favourable health indicators than those who do not.

2024 Systematic Review of Evidence-Based Guidelines for Prehospital Care

ABSTRACT Objectives Evidence-based guidelines (EBGs) are widely recognized as valuable tools to aggregate and translate scientific knowledge into clinical care. High-quality EBGs can also serve as important components of dissemination and implementation efforts focused on educating emergency medical services (EMS) clinicians about current evidence-based prehospital clinical care practices and operations. We aimed to perform the third biennial systematic review of prehospital EBGs to identify and assess the quality of prehospital EBGs published since 2021. Methods We systematically searched Ovid Medline and EMBASE from January 1, 2021, to June 6, 2023, for publications relevant to prehospital care, based on an organized review of the literature, and focused on providing recommendations for clinical care or operations. Included guidelines were appraised using the National Academy of Medicine (NAM) criteria for high-quality guidelines and scored using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Tool. Results We identified 33 new guidelines addressing clinical and operational topics of EMS medicine. The most addressed EMS core content areas were time-life critical conditions (n = 17, 51.5%), special clinical considerations (n = 15, 45%), and injury (n = 12, 36%). Seven (21%) guidelines included all elements of the National Academy of Medicine (NAM) criteria for high-quality guidelines, including the full reporting of a systematic review of the evidence. Guideline appraisals by the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool demonstrated modest compliance to reporting recommendations and similar overall quality compared to previously identified guidelines (mean overall domain score 67%, SD 12%), with Domain 5 (“Applicability”) scoring the lowest of the six AGREE II domains (mean score of 53%, SD 13%). Conclusions This updated systematic review identified and appraised recent guidelines addressing prehospital care and identifies important targets for education of EMS personnel. Continued opportunities exist for prehospital guideline developers to include comprehensive evidence-based reporting into guideline development to facilitate widespread implementation of high-quality EBGs in EMS systems and incorporate the best available scientific evidence into initial education and continued competency activities.