Prehospital Research Articles

The Use of PediSTAT Application by Paramedics Working in Saudi Arabia to Reduce the Risk of Medication Error for Pediatric Patients.

This study aimed to assess and compare the rates of medication error (ME) using the PediSTAT application compared to the conventional method of calculating the correct dose and determining the appropriate route of medication administration for common pediatric emergencies. A prospective cross-sectional study design was used for the study. Data were collected using a questionnaire that was distributed to certified paramedics holding a bachelor's degrees or higher and working in Riyadh City, Saudi Arabia. Alternate simple random sampling was used to recruit the participants into two groups using the same questionnaire: the PediSTAT group and the conventional method group. The questionnaire contained four pediatric emergency vignettes: cardiac arrest, asthma exacerbation, seizures, and hypoglycemia. A total of 63 participants agreed to the study. Almost 80% of them were males, 81% held bachelor's degrees, and 87% were certified in pediatric resuscitation courses. The findings of the study showed that the use of the PediSTAT application increased accuracy and reduced the risk of ME for common pediatric emergencies. This was shown to be statistically significant for asthma medication dose (p-value < 0.001, 95% CI 0.034-0.352), midazolam dose (p-value = 0.012, 95% CI 0.030-0.764), and hypoglycemia medication dose (p-value < 0.001, 95% CI 0.046, 0.452). The study findings supported the use of standardized precalculated applications such as PediSTAT, which was shown to reduce the risk of ME in prehospital care for pediatric emergencies.

Collaboration between ambulance services and primary care: a scoping review protocol

IntroductionMaking decisions about the appropriate level of care is a significant challenge for healthcare professionals, especially when older patients present with diffuse symptoms. Collaboration between ambulance services and primary care...

Road Accident Emergency Reporting Management System using Neural Network

Given the high number of road accidents that result in deaths every day, victims may lose their lives if emergency medical personnel or concerned parties fail to arrive promptly to intervene in an accident or if they do so, because they are unaware of the location of a nearby hospital or medical facility, they may not be able to provide the much-needed help. To avert this scenario, this research work seeks to deploy a Deep Learning Road Accident Emergencies Management model, which by examining of video and sensors’ data, identifies and reports traffic incidents in real time. A Neural Network (NN) is used by the model to recognize accident scenarios based on anomalous motion patterns inside video frames, including sudden halts and crashes. Put into practice in python, the program incorporates deep learning libraries such as OpenCV and TensorFlow for strong data processing and analysis in real time. To train and evaluate the model, an 80/20 data split, which results in reduced latency and high accuracy in accident detection. The Key performance metrics include a testing accuracy of 96%, an F1-score of 87.5%, and a response time of less than two seconds on average. The study advances the domains of artificial intelligence, transportation safety, and emergency management by offering a practical, real-time solution for automated accident reporting. This quick detection capability allows for timely emergency alerts, which are sent to responders via a web-based interface, giving them precise location details. The model's promise as a life-saving tool in smart city infrastructures is highlighted by its capacity to deliver precise and prompt replies. The Road Accident Emergency Reporting Model has important ramifications for increasing road safety, decreasing emergency response times, and boosting public safety in general due to its strong design and low latency.

Did court dismiss student's Title IX claim?

A 21‐year‐old student at Indiana University was found disoriented and partially nude on campus. The Indiana University Police Department responded to the incident, and emergency medical services transported her to IU Health Bloomington Hospital.

Fluid Resuscitation in the Prehospital Setting

Urban Emergency Medical Services benefit from an increased number of higher-level personnel (Advanced Emergency Medical Technicians and Paramedics) responding to all calls that are trained to obtain intravenous access. Current Advanced Trauma Life Support guidelines require all trauma patients to receive intravenous access, and as such it is essential for EMS clinicians to be conversant with situations which may require fluid resuscitation. These situations are especially common in rural or austere environments as long transport times require EMS clinicians to maintain adequate hemodynamics until arrival at a trauma center for definitive care. Historically, crystalloid solutions have been the mainstay of fluid resuscitation with Normal Saline or Lactated Ringer’s solution being preferred. Despite the recent shift in best practices from aggressive fluid resuscitation to delayed or significantly scaled back fluid resuscitation in most settings of trauma, it is essential for EMS clinicians to understand when fluid resuscitation is indicated, or, more importantly, contraindicated. EMS clinicians must be comfortable with the various fluids available to them in the field. This review provides an overview of the most common crystalloid fluids and blood component therapies which may be used for resuscitation in the prehospital setting.

Perception of undergraduate emergency medical services students about mental health

Mental illness significantly impacts morbidity and mortality; however, research on paramedic students' perceptions and attitudes toward individuals with mental health presentations is limite. The incidence of mental disorders in Saudi Arabia is increasing, and knowledge about them would enhance the ability of the paramedics to provide more help to the population. This study evaluates the perceptions of undergraduate emergency medical students before and after completing a mental health education block. We conducted a quasi-experimental design study for forth year students who were enrolled in a mental health block and have been added to King Saud bin Abdulaziz University for Health Sciences and were asked to partake in pre- and post-subject surveys. They were requested to share their perspectives on mental health through electronic questionnaires. With a total of 83 participants, averaging 21.33 years old, from three regions in Saudi Arabia, we found significant differences in the following questions before and after the mental health block: participants became more comfortable managing mental health issues (strongly agreeing increased from 10.8% to 36.1%). Moreover, perceptions about psychosis and violence changed (from agreeing to disagreeing). Questions on racism and trauma showed a significant increase in the strongly agreeing. The majority agreed more that neglect can cause mental illness (strongly agreeing increased from 30.1% to 63.9%). Lastly, exposure to rape was significantly strongly associated with mental disorders (69.9%, P value &lt;0.0001). Our study showed positive shifts in attitudes and increased mental health knowledge after introducing a mental health block. The block not only improved understanding but also holds promise for future paramedics in offering empathetic care. Overall, the study underscores the need for continuous mental health education in paramedic curricula for better readiness in addressing diverse population needs.

Navigating Emergency Management of Cancer Patients: A Retrospective Study on First-Time, End-Stage, and Other Established Diagnoses in a High Turnover Emergency County Hospital.

Background and Objectives: The incidence and prevalence of cancers are increasing worldwide, with special emphasis placed on prevention, early detection, and the development of new therapeutic strategies that strongly impact patient outcomes. Limited data are available about emergency care's role in treating patients with cancer. This study aims to determine the burden of end-stage and first-time diagnosis of cancer on emergency care in a high-turnover emergency care center. Materials and Methods: A retrospective observational study was conducted to identify patients requesting emergent aid for cancer-related symptoms in the Emergency Department of "St. Spiridon" Hospital from Iasi (Romania) between 1 October 2022 and 30 September 2023. The proportion and demographic characteristics of end-stage patients and those who received a first-time diagnosis during the emergency visit were evaluated. Risk analysis was performed to understand these patients' care needs (such as medical care, surgical care, specialty consults, intensive care, ward admission, and other hospital transfers) and immediate care outcomes (such as in-hospital mortality and home discharge). Results: 2318 patients with cancer requested emergent care (patient presentation rate of 3.08%), of which 444 (19.15%) were diagnosed for the first time, and 616 (26.57%) were at the end-stage. First-time diagnosed patients had a significantly different distribution of cancer types (p < 0.001), were more likely to need any form of medical care, to require a specialty consultation, or to be admitted to a ward (OR 2.65, 95% CI: 2.12-3.32; p < 0.001; OR 3.28, 95% CI: 2.48-4.35, p < 0.001; OR 2.09, 95% CI: 1.70-2.59; p < 0.001, respectively) but were less severe, while end-stage patients were more likely to address repeatedly to the emergency room (OR 1.86, 95% CI: 1.32-2.59; p = 0.001) and had higher odds of needing intensive care, assisted ventilation and death (OR-4.63, 95% CI: 1.10-19.45, p = 0.04; OR 2.59, 95% CI: 1.57-4.28; p < 0.001, and OR 4.06, 95% CI: 1.73-9.54; p = 0.001, respectively). Conclusions: The emergency department often carries the weight of diagnosing patients with cancer and treating patients with end-stage disease. These data highlight the importance of prehospital care, particularly for cancer screening and palliative care, and the importance of fostering multidisciplinary collaboration in the emergency room with oncologists, geriatricians, and palliative care specialists to improve patient outcomes.

The impact of pre-hospital emergency medical services on the outcomes of patients with burn: a systematic review and meta-analysis

Burn injuries are a worldwide health issue, significantly burdening healthcare facilities. Specialized burn centres are only sometimes available near the site of burn injury. First aid greatly impacted the outcomes of burns by evaluating the severity of the burn and associated injuries. Pre-hospital Emergency Medical Services (EMS) have more remarkable contributions to healthcare systems. We aimed to reveal the interventions provided by the EMS staff on the scene of burn injuries and the impact of these interventions on the outcomes of burn injuries. Furthermore, the study aimed to identify areas for improvement in pre-hospital burn care. A systematic literature review was carried out from inception to 1st July 2023 using twelve databases. All original articles that included patients with burn injuries who received the necessary pre-hospital care by EMS staff were included. Nine articles comprehending 6149 patients with burn injuries were retrieved. The analysis revealed that EMS interventions significantly improved the outcomes of burn management. This included better control for pain and vital parameters, and lower mortality risk. The EMS provided analgesic administration, cooling of the burn wound, and the necessary urgent therapies. However, the study identified a need for better EMS training in assessing burn severity and managing burn injuries effectively. Enhancing EMS providers' knowledge and skills in pre-hospital burn management could substantially improve patient outcomes and reduce the burden on healthcare systems. Improving the understanding of EMS providers towards burn care can minimize the risk of burn-related poor outcomes and reduce the burden on healthcare facilities.

Data from Emergency Medical Service Activities: A Novel Approach to Monitoring COVID-19 and Other Infectious Diseases.

Background: Italy, particularly the northern region of Lombardy, has experienced very high rates of COVID-19 cases and deaths. Several indicators, i.e., the number of new positive cases, deaths and hospitalizations, have been used to monitor virus spread, but all suffer from biases. The aim of this study was to evaluate an alternative data source from Emergency Medical Service (EMS) activities for COVID-19 monitoring. Methods: Calls to the emergency number (112) in Lombardy (years 2015-2022) were studied and their overlap with the COVID-19 pandemic, influenza and official mortality peaks were evaluated. Modeling it as a counting process, a specific cause contribution (i.e., COVID-19 symptoms, the "signal") was identified and enucleated from all other contributions (the "background"), and the latter was subtracted from the total observed number of calls using statistical methods for excess event estimation. Results: A total of 6,094,502 records were analyzed and filtered for respiratory and cardiological symptoms to identify potential COVID-19 patients, yielding 742,852 relevant records. Results show that EMS data mirrored the time series of cases or deaths in Lombardy, with good agreement also being found with seasonal flu outbreaks. Conclusions: This novel approach, combined with a machine learning predictive approach, could be a powerful public health tool to signal the start of disease outbreaks and monitor the spread of infectious diseases.

Editorial: Patient safety and patient-centred care in emergency medical services and adjoining care settings

Editorial: Patient safety and patient-centred care in emergency medical services and adjoining care settings

Public awareness of telephone number for medical emergencies: a scoping review.

Prompt activation of emergency medical services (EMS) constitutes the fundamental component of bystander response to time-dependent health crises. A clear understanding of the public ability to access EMS may help to guide interventions aimed at enhancing community preparedness for emergencies. This review was conducted to summarise studies that examined public knowledge of emergency phone numbers. The scoping review encompassed articles published since 2004 that reported the proportion of subjects who knew emergency phone numbers. Data sources included PubMed, Google Scholar and references of included articles. Relevant data from eligible publications were extracted manually to an author-developed data-charting sheet and analysed descriptively. Forty-eight articles were analysed. Reported studies, mostly cross-sectional surveys, were conducted in 26 countries, including 16 high-income, nine middle-income and one low-income country. The percentage of subjects who knew emergency numbers varied from 0.0 to 97.8 (median [interquartile range]: 64.3 [32.8-80.0]). For developed countries, it was significantly higher than for developing nations (69.6 [54.1-84.2] and 34.6 [19.4-61.5], respectively; p=0.003). The studies were generally inconsistent regarding the association of subjects' socio-demographic factors with knowledge of emergency numbers, suggesting the existence of geography-specific patterns. Available studies observed low community knowledge of emergency numbers, especially in developing countries, and suggest that the problem has a global scale. Further research efforts are required to determine the best strategies for enhancing the public ability to access EMS.

Barriers to Buprenorphine: A Case Series of Misadventures Implementing a Prehospital Buprenorphine Protocol.

While several studies have focused on preliminary data and outcomes associated with prehospital buprenorphine administration interventions, to date there has been little discussion of the challenges experienced during the initial implementation of a prehospital buprenorphine protocol.In this case series we examine 3 separate patient encounters with different crews, patients, and receiving emergency medicine (EM) physicians, which highlight initial challenges experienced with implementing the first prehospital buprenorphine program in a rural Appalachian County within South Carolina.In 2 cases we highlight conflicts that may require collegial intervention and education of local receiving EM physicians regarding the new prehospital protocol.In 1 case we describe a patient who was eligible but not enrolled due to a misunderstanding among an Emergency Medical Services (EMS) clinician of how to correctly apply protocol criteria. We discuss the management of each implementation issue and outcomes after follow-up with members of the study team.As these novel programs emerge, understanding the potential challenges and personal biases that may be encountered when implementing a prehospital buprenorphine administration protocol is essential to inform organizations planning to implement similar programs.

Freeze-dried plasma: Hemostasis and biophysical analyses for damage control resuscitation.

Effective hemorrhage protocols prioritize immediate hemostatic resuscitation to manage hemorrhagic shock. Prehospital resuscitation using blood products, such as whole blood or alternatively dried plasma in its absence, has the potential to improve outcomes in hemorrhagic shock patients. However, integrating blood products into prehospital care poses substantial logistical challenges due to issues with storage, transport, and administration in field environments. We utilized hemostatic assays and advanced biophysical techniques, such as calorimetry, infrared spectoscopy, dynamic light scattering,and biolayer interferometry, to compare the functional and structural properties of freeze-dried plasma (FDP; OctaplasLG Powder, Octapharma AB) with those of fresh plasma controls. Hemostatic characterization of FDP revealed that clot formation properties and coagulation parameters were largely comparable to fresh plasma controls, with some variations observed in Von Willebrand factor-ADAMTS13 axis and fibrinolysis. No change to moisture content of FDP (~1% water content) was observed after 6-month storage at ambient conditions. Biophysical analyses of FDP during transfusion demonstrated spontaneous exothermic mixing of FDP in plasma, a dilution effect from saline, as well as comparable stability to plasma controls. Quantification of ligand-binding affinities of platelet receptors activated GPIIbIIIa and GPIbα showed comparable binding properties to plasma controls. Our results show that FDP exhibits hemostatic functionality and protein stability on par with fresh plasma, as assessed by novel, highly sensitive techniques. FDP therefore represents a viable alternative to conventional plasma in damage control resuscitation, offering significant logistical and storage advantages for prehospital and remote applications, especially in scenarios where whole blood is unavailable.

Precipitated Withdrawal Induced by Prehospital Naloxone Administration

Objectives Buprenorphine is becoming a key component of prehospital management of opioid use disorder. It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine. The secondary objective was to identify associated factors contributing to precipitated withdrawal, including dose of naloxone administered, and identify rate of subsequent transport. Methods A retrospective cohort study reviewing electronic patient care reports (ePCRs) from March 2019 to April 2023 in a single Emergency Medical Services (EMS) system was performed. Cases were included if naloxone was administered during the prehospital interval and excluded if the patient was in cardiac arrest upon arrival and died on scene. Precipitated opioid withdrawal was defined using reliably available ePCR data points measured by the Clinical Opiate Withdrawal Scale: administration of an antiemetic or sedative, persistent tachycardia, or new tachycardia after naloxone. Descriptive statistics were calculated to quantify the incidence of precipitated withdrawal. Risk ratios were calculated to identify variables associated with outcomes of interest. A subgroup analysis was performed examining patients explicitly diagnosed with an overdose by EMS. Results During the study period, 4561 individuals were given naloxone, and 2124 (46.2%) met our proxy criteria for precipitated withdrawal. Patients who received multiple doses of naloxone were more likely to meet our precipitated withdrawal definition versus those who received a single dose (RR 1.2, 95% CI 1.12–1.28). Patients who experienced precipitated withdrawal were more likely to accept transportation than those who did not experience withdrawal (RR 1.08 95% CI 1.04–1.12). Persistent tachycardia (80.3%) was the most common criterion met for our definition of precipitated withdrawal. Conclusions Almost half of patients who received a dose of prehospital naloxone for suspected overdose met our proxy criteria for precipitated withdrawal. Patients who met our precipitated withdrawal definition were more likely to have received greater doses of naloxone and were more likely to accept transport to an emergency department.

OS DESAFIOS ENFRENTADOS PELOS PROFISSIONAIS DA ENFERMAGEM NO MANEJO DA COVID-19 DURANTE O ATENDIMENTO EM UPAS

The present study aimed to list the main challenges faced by health professionals in Emergency Care Units (UPAS) in the period pandemic, as well as the effects that these can have on the lives of professional’s emergencies in the same course. The interest in the topic arose due to the fact that the pandemic in Brazil and the world which had serious consequences for the general public, correlating it with effects on UPAS considered points of reference in the provision of urgent and emergency assistance. This is an integrative review of the literature, in which twelve articles published in the last ten years were selected and filtered by DeCS (Health Sciences Descriptors): Urgency; Emergency; COVID-19 and Pandemic, between the months of May to December 2020 in electronic databases: US National Library of Medicine (PUBMED), Medical Literature Analysis and Retrieval System Online (MEDLINE) and Google Scholar For results and discussions, twelve publications that met the inclusion criteria were analyzed. In this way, it is possible to highlight how important the work of these health professionals was and emphasize how the execution of team activities was carried out each time increasingly important for safe care, both for the patient and the community in general.

Factors Associated with Abusive Head Trauma in Young Children Presenting to Emergency Medical Services Using a Large Language Model

Objectives Abusive head trauma (AHT) is a leading cause of death in young children. Analyses of patient characteristics presenting to Emergency Medical Services (EMS) are often limited to structured data fields. Artificial Intelligence (AI) and Large Language Models (LLM) may identify rare presentations like AHT through factors not found in structured data. Our goal was to apply AI and LLM to EMS narrative documentation of young children to detect AHT. Methods This is a retrospective cohort study of EMS transports of children <36 months of age with a diagnosis of head injury from the 2018–2019 ESO Research Data Collaborative. Non-abusive closed head injury (NA-CHI) was distinguished from AHT and child maltreatment (AHT-CAN) through 2 expert reviewers; kappa statistic (k) assessed inter-rater reliability. A Natural Language Processing (NLP) framework using an LLM augmented with expert derived n-grams was developed to identify AHT-CAN. We compared test characteristics (sensitivity, specificity, negative predictive value (NPV)) between this NLP framework to a Generative Pretrained Transformer (GPT) or n-grams only models to detect AHT-CAN. Association of specific word tokens with AHT-CAN was analyzed using Pearson’s chi-square. Area Under the Receiver Operator Curve (AUROC) and Area Under the Precision-Recall Curve (AUPRC) are also reported. Results There were 1082 encounters in our cohort; 1030 (95.2%) NA-CHI and 52 (4.8%) AHT-CAN. Inter-rater agreement was substantial (k = 0.71). The augmented NLP framework had a specificity and sensitivity of 72.4% and 92.3%, respectively with a NPV of 99.5%. In comparison, the GPT model had a sensitivity of 69.2%, specificity of 97.1% and NPV of 98.4% and n-grams alone had a sensitivity of 53.8%, specificity of 62.0%, NPV of 96.4%. AUROC was 0.91 and AUPRC was 0.52. A total of 44 n-grams and bi-grams were positively associated with AHT-CAN including “domestic,” “various,” “bruise,” “cheek,” “multiple,” “doa,” “not respond,” “see EMS.” Conclusions AI and LLMs have high sensitivity and specificity to detect AHT-CAN in EMS free-text narratives. Words associated with physical signs of trauma are strongly associated with AHT-CAN. LLMs augmented with a list of n-grams may help EMS identify signs of trauma that aid in the detection of AHT in young children.

Optimal timing for epinephrine administration in adult patients with out-of-hospital cardiac arrest: A retrospective observational study.

This study aimed to clarify the appropriate timing for epinephrine administration in adults with out-of-hospital cardiac arrest (OHCA), particularly those cases with nonshockable rhythms, by addressing resuscitation time bias. We performed a retrospective observational study utilizing a multicenter OHCA registry involving 95 hospitals in Japan between June 2014 and December 2020. We included patients with OHCA and nonshockable rhythms who received epinephrine during resuscitation. The primary and secondary outcomes were favorable 30-day neurological status and survival, respectively. A favorable neurological outcome was defined as a cerebral performance category score of 1 or 2. The time from emergency medical service (EMS) personnel contact to epinephrine administration was categorized in 5-min intervals. We used the Fine-Gray regression to calculate the time-dependent propensity score in each group. After risk set matching, we employed a generalized estimating equation (GEE) to adjust for within-patient clustering. A total of 36,756 patients were included in the analysis. When involving timing variables and GEE, epinephrine administration significantly affected favorable 30-day neurological status at 1-5 and 6-10 min, with risk ratios (RR; 95% confidence intervals [CIs]) of 9.36 (1.19-73.7) and 3.67 (1.89-7.14), respectively. Epinephrine administration significantly affected 30-day survival at 1-5, 6-10, 11-15, and 16-20 min, with RRs (95% CIs) of 2.33 (1.41-3.85), 2.09 (1.65-2.65), 1.64 (1.32-2.05), or 1.70 (1.29-2.25), respectively. Epinephrine administration within 10 min of EMS personnel contact may be associated with favorable neurological outcomes in patients with OHCA and nonshockable rhythms.

Modelling emergency response times for Out-of-Hospital Cardiac Arrest (OHCA) patients in rural areas of the North of England using routinely collected data

BackgroundNational response time targets for ambulance services are known to be more strongly maintained in urban areas compared to rural. That may mean that responses in rural areas could be less immediate which can in turn affect survival of those experiencing cardiac arrest. Thus, analysis of variation in response times using routinely collected data can be used to understand which rural areas have the highest need for emergency intervention. In this study we have focused, given the heterogeneity of demographic make up, on a specific area of the North of England. Some areas in North England have shown to have a large proportion of cardiac arrests occurring in a rural setting, specifically, in the anonymised study region this was almost half of the cases at 46.3%. Response times to these areas were found to be over 3.5 minutes slower than for urban areas making it worthy of further exploration.MethodsA retrospective observation analysis was conducted on routinely collected data from regional ambulance services for areas within the North of England from April 2016 to March 2021. Information was collected on service and geographic characteristics for 1915 incidents. A multivariable linear mixed effect regression model was used to understand the association between geographical, service factors and response times to cardiac arrest patients. To advance previous research which up to now only used visualisations to analyse ambulance response times, the study used a mixed effects model with a variety of predictors, capturing geographical variation alongside service characteristics.ResultsFrom the cases analysed it was found that the mean response time to scene was 9.1 minutes, with a standard deviation of 6.4 minutes. After adjustment for geographic variation and incorporating robust standard errors into the model: distance to the nearest ambulance station (coefficient = 0.61, 95% confidence interval [CI]: 0.56-0.66), urgency of the call (Category 2, second most urgent, compared to the most urgent coefficient = 1.66, 95% CI: 1.13 - 2.18), location of the nearest ambulance station to the incident and the type of crew who attended the incident (Advanced Paramedic when compared to just Paramedic, coefficient = -0.70, 95% CI: -1.24 - -0.16) were all factors which affected response times to scene.ConclusionFor each extra km the incident was away from an ambulance station, the response time to scene increased by 37 seconds. The ambulance station which displayed the largest increase in response time, Station L was 170 seconds (95% CI: 79, 261) longer than Station N, which had a median performance across all stations, as measured by median survival rate to return of spontaneous circulation (ROSC). The rural geography of the North of England means that lots of cardiac arrest incidents occur a considerable distance away from the stations, emphasising the need to use alternative emergency services technologies within these rural areas to attend to patients sooner.

Criminalisation and Control: Mediterranean Maritime Search and Rescue Workers’ Perceptions of Uses of Law

Criminalisation and Control: Mediterranean Maritime Search and Rescue Workers’ Perceptions of Uses of Law

Undergraduate Students' Onlooker Response Prior to Arrival of Emergency Medical Services: An Assessment of Willingness to Respond.

This study sought to assess undergraduate students' knowledge and attitudes surrounding perceived self-efficacy and threats in various common emergencies in communities of higher education. Self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, obligation to respond, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond were investigated through 3 representative scenarios via a web-based survey. Among 970 respondents, approximately 60% reported their university had adequately prepared them for various emergencies while 84% reported the university should provide such training. Respondents with high self-efficacy were significantly more likely than those with low self-efficacy to be willing to respond in whatever capacity needed across all scenarios. There is a gap between perceived student preparedness for emergencies and training received. Students with high self-efficacy were the most likely to be willing to respond, which may be useful for future training initiatives.