EMS Training Research Articles

Effect of Whole-Body Electrical Muscle Stimulation Training on Inflammatory and Anti-inflammatory Cytokines in Overweight Men.

The aim of this study was to investigate the effects of whole-body electrical muscle stimulation (WB-EMS) training on inflammatory and anti-inflammatory cytokines in overweight men. We divided 30 participants into EMS and control groups. The training program for the EMS group comprised 20 WB-EMS sessions (7 weeks, three sessions per week). The results showed that EMS training caused significant increase in interferon γ (P<0.001) and interleukin 10 (IL-10; P<0.01) and significant decrease in IL-17 and IL-23 (P<0.05). Also, the lipid profile showed significant positive changes in the EMS training group. EMS training, a novel exercise method that uses electric stimulation, can affect the levels of various cytokines that are involved in inflammation and immunity. EMS training can have both beneficial and harmful effects on the body depending on the type and balance of involved cytokines.

Initial Validity Evidence for the American Board of Emergency Medicine Emergency Medical Services Certification Examination

Objectives The American Board of Emergency Medicine (ABEM) Emergency Medical Services Medicine (EMS) subspecialty was approved by the American Board of Medical Specialties on September 23, 2010. Subspecialty certification in EMS was contingent on two key elements—completing Accreditation Council for Graduate Medical Education (ACGME)-accredited EMS training and passing the subspecialty certification examination developed by ABEM. The first EMS certification examination was offered in October 2013. Meaningful certification requires rigorous assessment. In this instance, the EMS certification examination sought to embrace the tenets of validity, reliability, and fairness. For the purposes of this report, the sources of validity evidence were anchored on the EMS core content, the examination development process, and the association between fellowship training and passing the certification examination. Methods We chose to use validity evidence that included: 1) content validity (based on the EMS core content); 2) response processes (test items required intended cognitive processes); 3) internal structure supported by the internal relationships among items; 4) relations to other variables, specifically the association between examination performance and ACGME-accredited fellowship training; and 5) the consequences of testing. Results There is strong content validity evidence for the EMS examination based on the core content and its detailed development process. The core content and supporting job-task analysis was also used to define the examination blueprint. Internal structure support was evidenced by Cronbach’s coefficient alpha, which ranged from 0.82 to 0.92. Physicians who completed ACGME-accredited EMS fellowship training were more likely to pass the EMS certification examination (chi square, p < 0.0001; Cramér’s, V = 0.24). Finally, there were two sources of consequential validity evidence—use of test results to determine certification and use of the resulting certificate. Conclusions There is substantial and varied validity evidence to support the use of the EMS certifying examination in making summative decisions to award certification in EMS. Of note, there was a statistically significant association between ACGME-accredited fellowship training and passing the examination.

Body weight correction of adolescent girls by health fitness tools

The health condition of teenagers tends to deteriorate. In Ukraine, 30-40% of the population suffers from obesity, of which 15-17% are children and adolescents. In order to solve the mentioned problems, innovative modern fitness programs should be implemented, which would meet the needs of teenagers, contribute to increasing the level of their motor activity, improve general well-being, and save time. EMS training is one of these. In pediatrics, electrical stimulation is used for obesity. The modern vision of the use of electromyostimulation is a type of rehabilitation fitness, "fitness of the future".&#x0D; The purpose of the study was to correct the body weight of adolescent girls under the influence of EMS training. The study was conducted in the fitness club "JUSTFIT" with girls 15-16 years old (n=15) twice a week for 30 minutes. The pedagogical experiment has been lasted for 6 months. During the training, a special wireless EMS suit was used with pads on the hips and chest to which the electrodes were connected. Low-frequency electrical impulses were applied to them, which caused muscle contraction during exercise. EMS training included a warm-up (on the orbiterk), the main part (circular training in a moderate mode: cardio and strength training) and the hang up (relaxation - lymphatic drainage massage). The trainer individually selected the load, strength of impulses and formed the training process. EMS training gives quick results, thanks to the simultaneous training of all muscle groups during physical exercises.&#x0D; A statistically significant difference was established between the average values of all anthropometric indicators of girls 15-16 years old at the beginning and at the end of the pedagogical experiment (р&lt;0.05). Therefore, EMS training is considered a popular and effective fitness program.

Additional Active Movements Are Not Required for Strength Gains in the Untrained during Short-Term Whole-Body Electromyostimulation Training.

Recommendations for conventional strength training are well described, and the volume of research on whole-body electromyostimulation training (WB-EMS) is growing. The aim of the present study was to investigate whether active exercise movements during stimulation have a positive effect on strength gains. A total of 30 inactive subjects (28 completed the study) were randomly allocated into two training groups, the upper body group (UBG) and the lower body group (LBG). In the UBG (n = 15; age: 32 (25-36); body mass: 78.3 kg (53.1-114.3 kg)), WB-EMS was accompanied by exercise movements of the upper body and in the LBG (n = 13; age: 26 (20-35); body mass: 67.2 kg (47.4-100.3 kg)) by exercise movements of the lower body. Therefore, UBG served as a control when lower body strength was considered, and LBG served as a control when upper body strength was considered. Trunk exercises were performed under the same conditions in both groups. During the 20-min sessions, 12 repetitions were performed per exercise. In both groups, stimulation was performed with 350 μs wide square pulses at 85 Hz in biphasic mode, and stimulation intensity was 6-8 (scale 1-10). Isometric maximum strength was measured before and after the training (6 weeks set; one session/week) on 6 exercises for the upper body and 4 for the lower body. Isometric maximum strength was significantly higher after the EMS training in both groups in most test positions (UBG p < 0.001-0.031, r = 0.88-0.56; LBG p = 0.001-0.039, r = 0.88-0.57). Only for the left leg extension in the UBG (p = 0.100, r = 0.43) and for the biceps curl in the LBG (p = 0.221, r = 0.34) no changes were observed. Both groups showed similar absolute strength changes after EMS training. Body mass adjusted strength for the left arm pull increased more in the LBG group (p = 0.040, r = 0.39). Based on our results we conclude that concurring exercise movements during a short-term WB-EMS training period have no substantial influence on strength gains. People with health restrictions, beginners with no experience in strength training and people returning to training might be particularly suitable target groups, due to the low training effort. Supposedly, exercise movements become more relevant when initial adaptations to training are exhausted.

Effect of electromyostimulation training on intramuscular fat accumulation determined by ultrasonography in older adults.

PurposeElectromyostimulation (EMS) induces a short-term change in muscle metabolism, and EMS training induces long-term improvements of muscle atrophy and function. However, the effects of EMS training on intramuscular fat in older adults are still poorly known. The purpose of this study was to examine whether the intramuscular fat index and biochemical parameters change with EMS training of the quadriceps femoris muscles in older adults.MethodsNineteen non-obese older men and women performed EMS training of the quadriceps femoris for 12 weeks (3 times/week; single session for 30 min). The intramuscular fat content index was estimated by echo intensity of the vastus lateralis and rectus femoris muscles on ultrasonography, and muscle thickness was also measured. Muscle strength was assessed as the maximal voluntary contraction during isometric knee extension. Echo intensity, muscle thickness, and muscle strength were measured before and after EMS training. A rested/fasting blood samples were collected before and after EMS training for measuring plasma glucose, insulin, free fatty acid, triglyceride, and interleukin-6 concentrations. To examine the acute effect of a single-EMS session on biochemical parameters, blood samples were taken before and after the EMS session.ResultsEMS training did not significantly change echo intensity in muscles, muscle thickness, muscle strength, or biochemical parameters. Regarding the acute effect on blood lipid concentrations, a single-EMS session increased free fatty acid and glucose concentrations.ConclusionEMS sessions had an acute effect of increasing free fatty acid and glucose concentrations, but EMS training intervention did not improve intramuscular fat content.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00421-022-05074-3.

Effect of electromyostimulation and plyometrics training on sports-specific parameters in badminton players

Badminton is one of the world's most popular racquet sports, demanding motor skills such as agility and vertical jump mainly for striking a shuttlecock. This study compared the effects of four weeks of plyometric training and electromyostimulation of knee extensor and ankle plantar flexor muscles on agility, 30-m sprint, lower limb explosive power and jumping ability amongst badminton players. State-level badminton players (n ​= ​90) were randomly allocated into three groups: plyometric (PG), electromyostimulation (EG) and control group (CG), each with 30 players. Randomized-to-Groups Pretest-Posttest Design with two experimental (plyometric and electromyostimulation) groups and a control group was used. The plyometric training was carried out two times/week while the EMS training was four times/week for four weeks. The control group did not receive any intervention. All three groups continued their general badminton training throughout the study. Players were assessed for agility, a 30-m sprint, a standing broad jump and a vertical jump height before and after four weeks. A significant improvement (p ​= ​0.01) in 30-m sprint time was observed (3.83%) in PG as compared to controls. Jumping ability was significantly improved in both the PG and EG in comparison to the controls (4.45%, p ​= ​0.003 for PG and 3.95%, p ​= ​0.048 for EG). No significant improvement was found in agility and lower limb explosive power in either of the PG or EG groups in comparison to the controls. Plyometric training showed significant improvement in sprint time and jumping ability, whereas electromyostimulation training showed significant improvement only in jumping ability.

Effects Of Electrical Muscle Stimulation With Voluntary Pedaling Exercise On Skeletal Muscle Morphology And Function

PURPOSE: This study was to examine the effects of EMS while voluntary pedaling exercise for 8 weeks on the morphology and function of skeletal muscles. METHODS: Fifteen college age students (19-24) were randomly divided into EMS group; EMS only (n = 7) and EMS-EX group; EMS with voluntary pedaling (n = 8). They completed EMS training for 8 weeks (two times per weeks). The EMS group was performed EMS in a seated position, and the EMS-EX group was performed EMS with voluntary pedaling at 40-50 rpm with a very low load (0.5% of body weight) for 20 minutes, respectively. EMS was applied to the quadriceps muscle with the stimulator. The stimulator current waveform was set at a frequency of 50 Hz with a pulse width of 250 μs for both groups. Also, the stimulation intensity (mA) was set to the maximum intensity (23 to 60 mA) that they could tolerate for each session. We measured knee extension isometric and isokinetic strength (angular velocity60,120,180 deg/s), muscular endurance as skeletal muscle function, rectus femoris muscle thickness and thigh circumference as skeletal muscle morphology before and after 8 weeks of training. Each parameter was statistical analyzed by paired t-test were completed to identify any significant between-groups (p < 0.05). RESULTS: Knee extension isometric and isokinetic strength tended to increase after EMS training in both groups. But there was no difference in the changes between the two groups, the rate of increase in muscle strength in the EMS-EX group tended to be higher than that in the EMS group. Total work capacity and first 1/3 work capacity as muscular endurance were significantly increased in both groups(p < 0.05), but final 1/3 work capacity increased only in the EMS-EX group(EMS group; 99.3 ± 12.0%, EMS-EX group; 103.4 ± 9.5%) after EMS training. Rectus femoris muscle thickness of both group were significantly increased after EMS training (EMS group; 112.3 ± 5.6% and EMS-EX group; 111.7 ± 11.7%, p < 0.05). And thigh circumference in EMS-EX group was significantly increased after EMS training (p < 0.05). CONCLUSIONS: These results suggest that EMS would be induce increased isometric and isokinetic muscle strength and muscle hypertrophy. Furthermore, EMS training while voluntarily pedaling may be more effective than EMS alone in improving morphology and function of skeletal muscle.

Emergency Medical Services Provider Acceptance of and Attitudes About Pediatric SimBox Simulations.

SimBox simulations allow for high-frequency open-access health care education, overcoming cost and resource barriers. Prehospital paramedics and emergency medical technician (EMT) care for children infrequently. In this study, prehospital providers evaluated pediatric SimBox simulations. This was a cross-sectional study of EMS professionals participating in a series of simulations conducted in a larger project assessing improvement of the quality of pediatric care in the prehospital setting. Participants were teams of two, which comprised a paramedic/paramedic, paramedic/EMT, or 2 EMTs. The simulations used facilitator resources, debriefing prompts, video depictions of patients and vital signs, and a low-fidelity manikin. Pediatric emergency care coordinators, EMS training officers, and/or emergency physicians facilitated simulations of seizure, sepsis with respiratory failure, and child abuse, followed by debriefings. Participants completed an online survey after the simulation and rated it in 4 domains: prebriefing, scenario content, debriefing, and overall. Ratings were trifold: "strongly agree," "somewhat agree," or "do not agree." Data were analyzed by case type, participant type, location, participant reaction to simulation elements, and the debriefing. Net Promoter Scores were calculated to assess participant endorsement of SimBox. There were 121 participants: 103 (87%) were paramedics, and 18 (13%) were EMTs. Participant agreement of simulation benefit for clinical practice was high, for example, "I am more confident in my ability to prioritize care and interventions" (98.4% strongly or somewhat agree), and 99.2% of participants agreed the postsimulation debriefing with facilitators "provided opportunities to self-reflect on my performance during simulation." Overall, 97.5% strongly or somewhat agreed that the simulations "improved my comfort in pediatric acute care." Net Promoter Score showed 65.3% were promoters of and 24% were passive about SimBox. SimBox simulations are associated with improved self-efficacy of prehospital care providers for care of acutely ill or injured children. The majority promotes SimBox as a learning tool.

Application of EMS training system in physical training

Based on the research that EMS training system simulates the brain signal of human body and directly transmits the motion signal to the muscle to make the muscle contract strongly, this study makes a horizontal analysis and comparison of normal athletes, rehabilitation people, obese people, white-collar workers and other people, and makes a quantitative analysis. EMS training system is more efficient and effective than traditional training methods The advantage of convenience is to find a method to stimulate muscles through fast, effective and safe means, and find scientific and efficient training and rehabilitation methods for relevant people, which represents the future development direction of training and rehabilitation.

Challenges and Problems Affecting the Development Emergency Medical Services in Kosovo.

Emergency medical service is organized as a separate field of health activities in order to provide uninterrupted emergency medical care for citizens who due to illness or injury have directly threatened the life, certain organs or certain parts of the body respectively cut the optimal time of occurrence of the emergency until the start of the final treatment process. Emergence clinic for 2020. Year ED over 100. 000-cases. The emergency health system doesn’t have a consolidated network and integrated emergency medical services. Emergency health services in Europe are being challenged by changes in life dynamics, scientific advancements, which do increase the request to further improve the way of delivering emergency services. Health-system resilience can be defined as the capacity of health actors, institutions, and populations to prepare for and effectively respond to crises, to maintain core functions when a crisis hits, and—informed by lessons learned during the crisis to reorganize if conditions require it. Emergency clinic today at UCCK offers an area of 507m2, with 22 beds in the living room (1 bed per 100,000 population). Compliance with the law on emergency medical care, support, and improvement of EMS creating a special budget for EMS. EMS Independence (Decentralization). Budget, Management, accreditation, initiation of a project of systematization doctors of nurses in an integrated system. Regulation of administrative and legal infrastructure for EMS. The increase in salary (during holidays, weekends), shortening working hours for EMS, beneficial path (stress, risk, complexity, infections, first contact with the patient), the extension of annual leave. Functionalization of the Permanent National Center for Education EMS training, licensing, relicensing (medical staff) Quality control or EMS quality.

ВПЛИВ ФІЗКУЛЬТУРНО-ОЗДОРОВЧИХ ЗАНЯТЬ З ВИКОРИСТАННЯМ ЗАСОБІВ EMS-ТРЕНУВАННЯ НА ФІЗИЧНИЙ СТАН ЖІНОК ПЕРШОГО ПЕРІОДУ ЗРІЛОГО ВІКУ

Introduction. Nowadays each of us cares about health state, wellbeing, working capacity and methods how to increase that, to make it efficient. Solving eternal question, we have to focus our attention on the researches of physical education innovative methods, the usage of which will contribute towards human’s physical state level rise. The rapid pace of life literally wears out young women and men. Especially it refers to the early adulthood age women. Most of them during the day must combine work (which quite often leads to occupational disease), housekeeping, raising children and everyday life worries. Described women have only 1-3 free hours per day. The deficit of time to spare leads to inability of women to take care of self-health state and visit fitness classes. Such pastime allows to increase the level of physical state and consequently improve health state and working capacity. Therefore, the question of fitness classes optimization is the topical and can be solved with the usage of the latest technologies. One of these technologies is the EMS Xbody exercise machine, which is based on artificial electrical muscle stimulation. Classes using the EMS Xbody exercise machine for 30-45 minutes are equivalent to 1.5-2 hours of training in the gym, which is important for working women with no time to spare. In addition, the use of the EMS Xbody exercise machine causes a number of changes in the functional systems of a woman’s body, helps to increase her working capacity, and improves her fitness level. Hypothesis of research consists in a physical state improvement of the early adulthood age women who used EMS training tools during fitness classes. Purpose of research: determine an influence of the fitness classes with EMS training tools on the physical state of the early adulthood age women. Research methods: theoretical analysis and generalization of scientific-methodological literature, anthropometric methods, pedagogical testing, functional research methods, pedagogical experiment, methods of mathematical statistics. Research involved 8 early adulthood age women from 27 to 35 years old who are participants of the fitness studio "EMS Fit Studio", Dnipro and have no deviation in their health. Results: determined that the introduction of the EMS training methodology to the fitness classes process with early adulthood age women contributes to: lowering the heart rate, improving the functional reserves of the cardiovascular system and increasing the level of physical preparation. Conclusions. 1. The optimization process of fitness classes conducting with early adulthood age women is possible in case when EMS training tools are used, namely the EMS Xbody exercise machine, which is based on artificial electrical muscle stimulation.2. EMS training tools usage in the fitness classes conduction process and the selection of exercises (with taking into account the women professional activities peculiarities), help to improve the early adulthood age women physical state. Keywords: early adulthood age women, fitness classes, physical state, EMS training tools, EMS Xbody exercise machine.

Integrating Continuing Education Credits to a Collegiate EMS Training Model

Integrating Continuing Education Credits to a Collegiate EMS Training Model

A single-site pilot implementation of a novel trauma training program for prehospital providers in a resource-limited setting

BackgroundPrehospital (ambulance) care can reduce morbidity and mortality from trauma. Yet, there is a dearth of effective evidence-based interventions and implementation strategies. Emergency Medical Services Traumatic Shock Care (EMS-TruShoC) is a novel bundle of five core evidence-based trauma care interventions. High-Efficiency EMS Training (HEET) is an innovative training and sensitization program conducted during clinical shifts in ambulances. We assess the feasibility of implementing EMS-TruShoC using the HEET strategy, and feasibility of assessing implementation and clinical outcomes. Findings will inform a main trial.MethodsWe conducted a single-site, prospective cohort, multi-methods pilot implementation study in Western Cape EMS system of South Africa. Of the 120 providers at the study site, 12 were trainers and the remaining were eligible learners. Feasibility of implementation was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. Feasibility of assessing clinical outcomes was assessed using shock indices and clinical quality of care scores, collected via abstraction of patients’ prehospital trauma charts. Thresholds for progression to a main trial were developed a priori.ResultsThe average of all implementation indices was 83% (standard deviation = 10.3). Reach of the HEET program was high, with 84% learners completing at least 75% of training modules. Comparing the proportion of learners attaining perfect scores in post- versus pre-implementation assessments, there was an 8-fold (52% vs. 6%) improvement in knowledge, 3-fold (39% vs. 12%) improvement in skills, and 2-fold (42% vs. 21%) increase in self-efficacy. Clinical outcomes data were successfully calculated—there were clinically significant improvements in shock indices and quality of prehospital trauma care in the post- versus pre-implementation phases. Adoption of HEET was good, evidenced by 83% of facilitator participation in trainings, and 100% of surveyed stakeholders indicating good programmatic fit for their organization. Stakeholders responded that HEET was a sustainable educational solution that aligned well with their organization. Implementation fidelity was very high; 90% of the HEET intervention and 77% of the implementation strategy were delivered as originally planned. Participants provided very positive feedback, and explained that on-the-job timing enhanced their participation. Maintenance was not relevant to assess in this pilot study.ConclusionsWe successfully implemented the EMS-TruShoC educational intervention using the HEET training strategy in a single-site pilot study conducted in a low-resource international setting. All clinical outcomes were successfully calculated. Overall, this pilot study suggests high feasibility of our future, planned experimental trial.

Effects of electromyostimulation training on jumping and muscle strength in football players

Purpose: Electromyostimulation is a popular training to increase muscle strength during the last years. The aim of this study was to investigate effects of electromyostimulation training on jumping and muscle strength in football players. Material: Volunteered 23 football players between the ages of 18 to 24 were divided into experimental and control groups with simple random sampling. Both groups continued to regular training. Experimental group had additional electromyostimulation training for 6-week, 3-time a week, and 20min a day. Pre- and post-training squat and countermovement jumps, peak torques of dominant and non-dominant knee extensor and flexor muscles were tested. Angular velocities of isokinetic dynamometer were 60, 180, and 300ºs-1. Pre- and post-test comparisons within the groups were analyzed. Results: There were no significant differences between pre- and post-test for isokinetic knee strength parameters at all angular velocities of EG. However, control group had significant pre- and post-test differences in dominant and non-dominant knee extension and flexion peak torque values. Conclusions: EMS and regular training in-season had no effect on the isokinetic strength parameters. On the other hand, the regular training in-season has increased isokinetic strength. Electromyostimulation training additional to regular training may have detrimental effects on outcomes of concurrent training in football players.

Abstract WP305: Field Assessment of Potential Large Vessel Occlusions in Patients With Suspected Acute Ischemic Stroke: Results From a Clinician Survey

Introduction: Acute ischemic stroke (AIS) caused by large vessel occlusions (LVOs) has high morbidity and mortality. Reliable prehospital identification of LVOs may improve patient care, hospital routing and ultimately outcomes. This analysis characterizes current expert opinion on preferred stroke scales for field assessment of LVOs, factors driving scale preferences and associated research data gaps in a sample of multidisciplinary key stakeholders who care for patients with AIS. Methods: In total, 248 HCPs from 4 specific disciplines responsible for AIS patient care were asked to participate in an in-person survey. The survey was administered by trained interviewers using structured interviews between Sep 2017 and Jan 2018. Responses were analyzed overall and stratified by HCP type with descriptive statistics. Results: Of 169 participating HCPs, 22% were general neurologists, 25% neuro-interventionalists, 24% emergency department physicians (38% emergency medical system [EMS] directors), 26% stroke coordinators and 2% other. Most respondents were from comprehensive stroke centers (64%) and represented a broad US geography. Among the respondents, 86% agreed or strongly agreed that prehospital stroke scales are effective in identifying LVOs, and 63% (n=107) had a preferred prehospital LVO scale ( Table ). Among those who stated a preference (n=107), 65% cited practical considerations for their choice (eg, ease of use, already in use by local EMS) and 46% cited the scale’s properties (psychometric or clinical). Regarding the greatest need in the prehospital assessment of stroke (n=169), 56% of respondents called for more research on LVO scales, 24% for other prehospital assessment tools and 26% for EMS training and standardization. Conclusions: The majority of HCPs surveyed support the use of prehospital LVO scales but request further research. No one scale was preferred over another.

Comparison of Physical Parameters of the Individuals Who Have Received NASM-OPT Model &amp; EMS Training in Combination With Traditional Fitness Training Applications Regularly as Personal Training (PT) for 20 Weeks

In the study, it is aimed to determine whether there is any improvement in the physical performance development of the individuals, who have made exercise with OPT MODEL -EMS mix. and traditional PT models within the 20-week exercise program. In the study, pre-test, posttest, experimental screening by pattern methods are used. Study groups consist of 30 individuals, who are healthy and voluntary, continuing the fitness centers in Netherlands (OPT-EMS; n=30) and in Turkey (PT; n=30). After the data obtained is entered in computer environment; the arithmetic means (X), standard deviations (ss) of the research groups are taken and the Paired Samples t-test is applied for the differences between the pre-test and posttest. Significance level is examined at p&lt;0.05 level. When the study findings are examined, statistically significant differences are observed in the push-up, squat, crunch, plank and Max Vo2 performance measurements of the participants in 20-week OPT-EMS group (p&lt;0.05). Also, a statistically significant difference is found in the left hand grip and plant test performance measurements of the participants in 20-week PT group (p&lt;0.05).As a result, the OPT model, which is an innovative approach and has five different training phases, and the continuation of training with EMG for a certain period of time can be said to contribute to the physical performance. In addition, in case PT training content is prepared according to the individual, it is considered that it will contribute to physical performance.

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect

BackgroundEmergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. ObjectiveTo explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. MethodsFive semi-structured focus groups with 27 EMS providers. ResultsParticipants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. ConclusionsEMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified.

Study of Pre-hospital Emergency Care Assessment on Burned Patients Referred to Hospitals in Tabriz, Northwest Iran

Background: In all burn care systems; first aid, covering, and transferring burn-injury patients to the hospital all have an important role in managing and achieving a successful outcome. It seems there are wide differences in the main methods of providing first aid and pre-hospital care on burn patients. Despite several researches, the epidemiological specifications, level of care, as well as offered treatments is various in different regions. Objectives: This study was performed to determine the various aspects of pre-hospital management of burn patients in Sina and other hospitals affiliated to the Tabriz University of Medical Sciences. Methods: In this retrospective study, data of 100 patients admitted from 2014 to 2015 were collected. According to the standard questionnaire, transferring patients, training of technicians, and quality of pre-hospital treatment were checked out and recorded in the questionnaires, then data were analyzed by the SPSS v.21 software. Results: Regarding the status of EMS technicians, only 30% of them were trained; in 22% of accidents, before dispatching, coordination with the burn center had been done. The total mortality rate was 13%. In all the burn cases reported, temperature regulation of inner ambulance environment hadn’t been measured. Conclusions: The results of this study showed that the level of emergency burn management and training is relatively low and therefore the strengthening of pre-hospital emergency management training is recommended. In order to prevent and reduce the incidence and mortality rate of burns, short and long term plans should be formulated. It is recommended that courses such as EMS training for technicians in the field of pre-hospital care, burn training in the hospitals for proper communication, and transferring to a primary care center needed to be done.

Influence of Family on Saudi Arabian Emergency Medical Services Students

&lt;p&gt;Objective: To identify influences on learning for Saudi male students studying Emergency Medical Services at a college in Riyadh, Saudi Arabia. Previous research on influences on student learning in the Kingdom of Saudi Arabia focused on the historical development of education in Saudi Arabia, English language development, and intrinsic motivations of students and excluded a focus on students studying Emergency Medical Services. Methods: Exploratory sequential mixed-methods study was deployed. Results: Family support was an exceptionally strong predictor of student confidence in both skills and post-graduate EMS employment. Concepts involving application, memorization, motivation, and English language did not present as statically significant. The discovery of the strong influences that a family can have on Saudi EMS student’s confidence is noteworthy, as this was not previously discovered in the literature. Conclusion: This discovery holds practical implications for EMS education and training programs as emphasizes the importance of developing practical ways to include a student’s family as a source of support in ensuring student success and confidence. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Abstract WP272: Impact of Stroke Legislation on Developing Stroke Systems of Care and Improving Acute Therapy

Background: Stroke is the 4th leading cause of death in Illinois and the leading cause of disability. In 2009, Illinois passed stroke legislation to establish a Stroke Advisory Sub-committee to advise the State EMS Advisory Council. Legislation also created 11 multidisciplinary EMS Regional Stroke Advisory Subcommittees, recognition of certified Primary Stroke Centers, state designation of Emergent Stroke Ready hospitals and updating of EMS routing protocols. In 2014, updated legislation was passed to include state recognition of nationally certified Comprehensive Stroke Centers (CSC), updating of EMS routing protocols to include CSC’s and establish a state stroke fund created from hospital designation fees. Hypothesis: Implementation of Illinois’s stroke legislation by EMS region enhances systems of care collaboration between hospitals and EMS providers and improves timely intervention for patients with acute ischemic stroke. Methods: We queried the state-wide AHA’s Get With The Guideline stroke registry, which captured 72% of Illinois stroke discharges from 2009 through 2015. In total, 90 hospitals entered data, 57 from PSCs, 8 from CSCs, and 25 from Emergent Stroke Ready hospitals. All patients included in the registry as confirmed stroke were included for analysis. Hospital time and treatment data were recorded in an aggregate manner. Descriptive statistics were used to report results. Results: The total number of confirmed stroke patients treated was 123,859 Median door-to-needle (DTN) times for IV tPA therapy went from 85 minutes in 2009 to 56 in 2015 . The percent of acute ischemic stroke patients with a door-to-needle time of 60 minutes or less increased from 18.0% in 2009 to 62.9% in 2015. Conclusions: The decrease in DTN from 2009 to 2015 is an indicator of improved care due to the Illinois stroke system of care model. This is a good example of all system stakeholders including state government and EMS working collaboratively to improve care. Which elements of a stroke system are responsible for this improvement (hospital designation, routing, EMS training) will require further research. Regional coordination of resources and state hospital designation may impact prehospital routing of suspected strokes and may improve patient outcomes.