Emergency Medical Technician Students Research Articles

Association Between Pandemic-Related Instructional Delivery Modifications and Emergency Medical Technician (EMT) First Attempt Pass Rates

Background: The COVID-19 pandemic represents a sentinel event for healthcare and healthcare education alike. Mandatory shutdowns of educational institutions, combined with increased demand for skilled healthcare personnel, highlighted pre-existing challenges surrounding how to maintain a stable workforce. To ensure continuity of educational opportunities, many emergency medical services (EMS) educational institutions were forced to modify existing learning method to digital learning formats. This emergent transition unearthed concerns regarding the impacts alternative learning methods would have on entry-level EMS providers' learning outcomes and overall competency levels. The objective of this study was to investigate the impact of alternative instructional methods used for EMT education during the COVID-19 pandemic. Methods: The study is a retrospective review of prospectively collected data for EMT candidates from a single community college-based EMT program who completed a first attempt of the National Registry EMS Certification examination for EMT candidates from course sections ending between January 1, 2019, and December 31, 2020. Historical pre-COVID first attempt exam outcomes were compared to the first attempt outcomes of two alternative instructional methods –Emergency Remote (ER) and COVID Distance Learning Hybrid (DL). Results: The outcomes of 237 EMT students were evaluated. Remote and COVID Hybrid DL models compared to the traditional pre-COVID learning format. There was no significant difference in first attempt pass rates between students who participated in traditional learning, the Emergency Remote model (1.53 odds ratio), or the Distance Learning model (2.98 odds ratio). Conclusions: This study suggests that virtual learning is at least as effective as traditional formats in preparing students for the NREMT examination. Additional research is warranted regarding best practices for applying virtual learning modalities in EMS education.

The Impact of the Addition of a Virtual Reality Trainer on Skill Retention of Tourniquet Application for Hemorrhage Control Among Emergency Medical Technician Students: A Pilot Study.

Trauma is a leading cause of preventable death in the United States. Emergency Medical Technicians (EMTs) often arrive first at the scene of traumatic injuries to perform life-saving skills such as tourniquet placement. While current EMT courses teach and test tourniquet application, studies have shown efficacy and retention of EMT skills such as tourniquet placement decay over time, with educational interventions needed to improve retention of skills. A prospective randomized pilot study was conducted to determine differences in retention of tourniquet placement among 40 EMT students after initial training. Participants were randomly assigned to either a virtual reality (VR) intervention or a control group. The VR group received instruction from a refresher VR program 35 days after initial training as a supplement to their EMT course. Both the VR and control participants' tourniquet skills were assessed 70 days after initial training by blinded instructors. Results: There was no significant difference in correct tourniquet placement between both groups (Control, 63% vs Intervention, 57%, p = 0.57). It was found that 9/21 participants (43%) in the VR intervention group failed to correctly apply the tourniquet while 7/19 of the control participants (37%) failed in tourniquet application. Additionally, the VR group was more likely to fail the tourniquet application due to improper tightening than the control group during the final assessment (p = 0.04). Conclusion: In this pilot study, using a VR headset in conjunction with in-person training did not improve the efficacy and retention of tourniquet placement skills. Participants who received the VR intervention were more likely to have errors relating to haptics, rather than procedure-related errors.

Psychophysiological Responses in Emergency Medical Technician Students during Simulated Work Activities in a Hot Environment.

This study compared physiological responses and cognitive performance during simulated work activities in heat to a thermoneutral condition. First responders perform physically demanding activities in a hot environment which may impose additional burdens on tactical personnel during daily tasks. Ten healthy (8 men and 2 women) participants performed two consecutive simulated work activities with two repetitions of each activity (10 min walking on treadmill and 15 sandbag lifts) under heat and thermoneutral conditions. A Stroop color word test (SCWT) and total mood disturbance (TMD) were obtained at first and second baseline (B1, B2), after a 30-min resting period (B3), and recovery (R1). At the end of the trial, core temperature (Tc), skin temperature (tsk), and mean body temperature (Tb) were higher in the heat condition compared to neutral condition (all p ≤ 0.05), whereas oxygen uptake, heart rate, and mean arterial pressure were not significantly different between conditions. There were no differences in scores of SCWT and TMD between conditions. However, TMD was significantly improved after two successive bouts of exercise compared to B3 (all p ≤ 0.05). This investigation shows that two successive simulated work activities did not induce the detrimental influence on thermoregulatory and cognitive responses. Extended work activities in a hot and humid environment may impose a psychophysiological burden and need to be investigated.

Physical Activity and Health Habits Among Emergency Medical Technician Students

Physical Activity and Health Habits Among Emergency Medical Technician Students

응급구조과 학생의 환자안전에 대한 지식 및 태도가 환자안전관리 자신감에 미치는 영향

응급구조과 학생의 환자안전에 대한 지식 및 태도가 환자안전관리 자신감에 미치는 영향

Comparison between an instructor-led course and training using a voice advisory manikin in initial cardiopulmonary resuscitation skill acquisition

ObjectiveWe compared training using a voice advisory manikin (VAM) with an instructor-led (IL) course in terms of acquisition of initial cardiopulmonary resuscitation (CPR) skills, as defined by the 2010 resuscitation guidelines.MethodsThis study was a randomized, controlled, blinded, parallel-group trial. We recruited 82 first-year emergency medical technician students and distributed them randomly into two groups: the IL group (n=41) and the VAM group (n=37). In the IL-group, participants were trained in “single-rescuer, adult CPR” according to the American Heart Association’s Basic Life Support course for healthcare providers. In the VAM group, all subjects received a 20-minute lesson about CPR. After the lesson, each student trained individually with the VAM for 1 hour, receiving real-time feedback. After the training, all subjects were evaluated as they performed basic CPR (30 compressions, 2 ventilations) for 4 minutes.ResultsThe proportion of participants with a mean compression depth ≥50 mm was 34.1% in the IL group and 27.0% in the VAM group, and the proportion with a mean compression depth ≥40 mm had increased significantly in both groups compared with ≥50 mm (IL group, 82.9%; VAM group, 86.5%). However, no significant differences were detected between the groups in this regard. The proportion of ventilations of the appropriate volume was relatively low in both groups (IL group, 26.4%; VAM group, 12.5%; P=0.396).ConclusionBoth methods, the IL training using a practice-while-watching video and the VAM training, facilitated initial CPR skill acquisition, especially in terms of correct chest compression.

Board 323 - Research Abstract Evaluation of Knowledge and Confidence Changes Using Simulation Versus Traditional Teaching Methods for the Education of Emergency Medical Technician Students in the Care of Obstetric and Neonatal Patients (Submission #776)

Board 323 - Research Abstract Evaluation of Knowledge and Confidence Changes Using Simulation Versus Traditional Teaching Methods for the Education of Emergency Medical Technician Students in the Care of Obstetric and Neonatal Patients (Submission #776)

응급구조과 학생의 병원감염 표준주의에 대한 인지도와 수행도

이 연구는 임상실습을 실시하면서 병원감염에 노출되어 있는 응급구조과 학생들을 대상으로 병원감염관리 표준주의 지침의 인지도와 수행도를 파악함으로써 감염예방과 노출을 감소시킬 수 있는 효율적인 실천방안을 마련하는데 기초자료를 제공하고자 하였다. 연구결과 병원감염관리 표준주의 인지도에 비해 수행도가 낮은 결과를 보였고, 인지도와 수행도는 양의 상관관계가 있는 것으로 나타났으며 통계적으로 유의한 차이가 있었다(r=0.325, p=0.000). 향후 응급구조과 학생들의 병원감염관리 수행도를 증진 시킬 수 있도록 교과과정과 실습기관에서의 지속적인 교육프로그램이 수행되어야 할 것이다. This study was to provide the basic data to raise the efficient practices that can reduce the Infection Prevention and Exposure by understanding the awareness, Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control for Emergency Medical Technician students who are exposed to hospital infections while conducting clinical practice. After the study, the performance degree was lower than the awareness of the Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control. And awareness and performance degree are have significant positive correlation, significant differences statistically(r=0.325, p=0.000). In the future, to improve the Performance degree of Nosocomial Infection Control for Emergency Medical Technician students, the continuing education programs and the curriculums should be performed in the practice agencies.

The Prevalence of Methicillin-Resistant Staphylococcus Aureus among Out-of-Hospital Care Providers and Emergency Medical Technician Students

Objective. We compared the methicillin-resistant Staphylococcus aureus (MRSA) carrier rate among out-of-hospital care providers with greater than six months’ experience in emergency medical services (EMS) care with that of emergency medical technician (EMT) students with two months or less of observation time as part of their clinical training. Methods. We conducted a prospective study utilizing a convenience sample of out-of-hospital care providers and EMT students in an urban EMS system operating in the Midwest during October and November 2006. One hundred thirty-four out-of-hospital care providers and 152 EMT students were tested for MRSA susceptibility using the cefoxitin disk diffusion method. Results. Contrary to our hypothesis, we did not find a statistically significant difference in MRSA nasal colonization between out-of-hospital care providers (4.5%; 95% confidence interval [CI] 1.0, 8.0) and EMT students (5.3%; 95% CI 1.7, 8.8). A subgroup analysis showed that among out-of-hospital care providers, paramedics had a higher rate of nasal colonization than EMTs (5.6% vs. 2.2%). Conclusion. We found that out-of-hospital care providers and EMT students had higher nasal colonization rates than the reported rate for the U.S. population (0.084% at the time the study was conducted and 1.5% currently). It is imperative that both groups adhere to infection control practices.

A Randomized, Controlled Comparison of Cardiopulmonary Resuscitation Performed on the Floor andon a Moving Ambulance Stretcher

Background. Recent studies have demonstrated that cardiopulmonary resuscitation (CPR) of poor quality is associated with worsened outcomes. Objective. To compare the quality of CPR delivered on the floor with the quality of CPR delivered on a moving stretcher. The authors hypothesized that CPR performed on the floor would be superior to that performed on a moving stretcher. Methods. A randomized, crossover experimental design was used. Subjects included emergency medical technician students, paramedic students, andemergency medicine residents. Two-member teams were randomly assigned to perform two-rescuer CPR on a manikin either on the floor or on a moving stretcher. After a 5-minute rest, the teams performed CPR under the opposite condition. Compression andventilation data were collected using a recording resuscitation manikin. Dependent variables were compression depth, compression rate per minute, percentage of correct chest compressions, tidal volume, andpercentage of correct ventilations. Data were compared using two-tailed paired t-test. Results. Sixty-two subjects completed the study. The mean compression depth performed on the floor (39 ± 9 mm) was greater than that on a moving stretcher (28 ± 9 mm) (p < 0.001). The mean rates of chest compressions on the floor (110 ± 17 beats/min) andon a moving stretcher (113 ± 21 beats/min) were not different (p = 0.49). The percentage of correct compressions performed on the floor (54% ± 40%) exceeded that on a moving stretcher (21% ± 29%)(p < 0.001). The percentage of correct ventilations performed on the floor (43% ± 26%) was greater than that on a moving stretcher (24% ± 21%)(p < 0.04). Conclusions. Chest compression andventilation quality of CPR performed on the floor was superior to that of CPR performed on a moving stretcher in this manikin model. The quality of CPR while moving was significantly compromised.

A Comparison of the Laryngeal Tube and Bag-Valve Mask Ventilation by Emergency Medical Technicians: A Feasibility Study in Anesthetized Patients

Airway management is of major importance in emergency care. The basic technique for all health care providers is bag-valve mask (BVM) ventilation, which requires skill and may be difficult to perform. Endotracheal intubation, which is the advanced method for securing the airway, is a demanding technique that has been shown to be associated with infrequent success, even when used by experienced paramedical personnel. Therefore, alternative airway devices have been sought. The use of the laryngeal tube (LT) by experienced anesthesia personnel had been studied in anesthetized patients and manikins in emergency medical training. We decided to evaluate the ability of inexperienced firefighter-emergency medical technician students (fire-EMT) to insert the LT or perform BVM in anesthetized patients. Thirty fire-EMTs randomly inserted the LT (n = 15) and performed 1 min of ventilation or used the BVM (n = 15). We found that all students successfully (100%) inserted the LT. Those who inserted the LT on the first attempt (73%) required 48.2 +/- 14.7 s for the insertion. Both the LT and BVM provided adequate oxygenation and ventilation. In this study, we found that inexperienced fire-EMT students inserted LT and performed 1-min ventilation with a reasonable success rate and insertion time in anesthetized patients.

Over-the-Head Cardiopulmonary Resuscitation Improves Efficacy in Basic Life Support Performed by Professional Medical Personnel with a Single Rescuer: A Simulation Study

Two-rescuer cardiopulmonary resuscitation (CPR) is considered the best method for professional basic life support (BLS). However, in many prehospital cardiac arrest situations, one rescuer has to begin CPR alone while the other performs additional tasks. In theory, over-the-head CPR is a suitable alternative in this situation, with the added benefit of allowing the single rescuer to use a self-inflating bag for ventilation. In this trial, we compared standard single-rescuer CPR with over-the-head CPR in manikins. We planned this study using a crossover study design where each participant administered both CPR techniques in a randomized order. Ventilation and chest compression data were collected with analysis software during a 2-min CPR test for each technique. Sixty-seven emergency medical technician students participated in this trial. Over-the-head CPR allowed for superior ventilation compared to standard CPR (number of correct ventilations: 330 of 760 versus 279 of 779; P = 0.002). The quality of delivered chest compressions did not differ between the two groups (correct chest compressions: 4293 of 6304 versus 4313 of 6395; P = 0.44). In conclusion, our study has shown that over-the-head CPR may be an effective alternative BLS technique when a single professional rescuer has to perform CPR, likely offering superior ventilation and comparable chest compression quality compared with standard BLS.

M AXIMIZING C OMFORT AND M INIMIZING I SCHEMIA : A C OMPARISON OF F OUR M ETHODS OF S PINAL I MMOBILIZATION

Objective. To determine which of four methods of spinal immobilization causes the least ischemic pain. Methods. A prospective, nonblinded comparative trial was conducted at a statewide emergency medical services training facility using a convenience sample of emergency medical technician students. After lying motionless for 10 minutes, students evaluated each device using a 10-centimeter visual analog scale. Subjective comfort was used as a measure of ischemia. Results. Comfort scores were significantly different for all methods (F = 101, p 1 < 0.001). A backboard padded with a gurney mattress and eggcrate foam (the equivalent of a spinal rehabilitation bed) caused the least ischemic pain (9.6 cm, 95% CI, 8.9 to 9.8 cm). A backboard padded with a gurney mattress was the second most comfortable device (7.0 cm, 95% CI, 6.4 to 7.4 cm). A backboard padded with a folded blanket was the third most comfortable (3.3 cm, 95% CI, 2.6 to 4.9 cm). The backboard alone caused the most pain (0.8 cm, 95% CI, 0.7 to 2.1 cm). Conclusion. Increasing the amount of padding on a backboard decreased the amount of ischemic pain caused by immobilization.