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Roger Levine - One of the best experts on this subject based on the ideXlab platform.
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longitudinal Emergency Medical Technician attributes and demographic study leads design and methodology
Prehospital and Disaster Medicine, 2016Co-Authors: Roger LevineAbstract:Objectives The objective of this study is to describe the Longitudinal Emergency Medical Technician (EMT) Attributes and Demographic Study (LEADS) design, instrument development, pilot testing, sampling procedures, and data collection methodology. Response rates are provided, along with results of follow-up surveys of non-responders (NRs) and a special survey of Emergency Medical Services (EMS) professionals who were not nationally certified. Methods Annual surveys from 1999 to 2008 were mailed out to a random, stratified sample of nationally registered EMT-Basics and Paramedics. Survey weights were developed to reflect each respondent's probability of selection. A special survey of NRs was mailed out to individuals who did not respond to the annual survey to estimate the probable extent and direction of response bias. Individuals who indicated they were no longer in the profession were mailed a special exit survey to determine their reasons for leaving EMS. Results Given the large number of comparisons between NR and regular (annual) survey respondents, it is not surprising that some statistically significant differences were found. In general, there were few differences. However, NRs tended to report higher annual EMS incomes, were younger, healthier, more physically fit, and were more likely to report that they were not practicing EMS. Comparisons of the nationally certified EMS professionals with EMS professionals who were not nationally certified indicated that nationally certified EMS providers were younger, had less EMS experiences, earned less, were more likely to be female and work for private EMS services, and less likely to work for fire-based services. These differences may reflect state and local policy and practice, since many states and local agencies do not require maintenance of national certification as a requirement to practice. When these differences were controlled for statistically, there were few systematic differences between non-nationally certified and nationally certified EMS professionals. Conclusions The LEADS study is the only national, randomized, and longitudinal data source for studying EMS professionals in the United States. Although not without flaws, this study remains an excellent source of information about EMS provider demographics, attributes, attitudes, workplace issues and concerns, and how the profession has changed from 1999 to 2008. Levine R . Longitudinal Emergency Medical Technician Attributes and Demographic Study (LEADS) design and methodology. Prehosp Disaster Med. 2016;31(Suppl. 1):s7-s17.
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the longitudinal Emergency Medical Technician emt attributes and demographics study leads the first 10 years and a look at public perception of Emergency Medical services ems
Prehospital and Disaster Medicine, 2016Co-Authors: Remle P Crowe, Melissa A Bentley, Roger LevineAbstract:Crowe RP , Bentley MA , Levine R . The Longitudinal Emergency Medical Technician (EMT) Attributes and Demographics Study (LEADS): the first 10 years and a look at public perception of Emergency Medical Services (EMS). Prehosp Disaster Med. 2016;31(Suppl. 1):s1-s6.
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American Institutes for Research
2016Co-Authors: Darlene Russ-eft, Phil Dickison, Roger LevineAbstract:This study examines the relationship between certification examination test results and Emergency Medical Technician (EMT) career success. The sample was drawn from the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). LEADS participants were matched with National Registry of Emergency Medical Technician (NREMT) certification testing data: (1) exam scores for each attempt until passing the exam, and (2) total number of attempts to pass the exam. Career success was measured both objectively and subjectively
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certification and career success a leads project
2008Co-Authors: Darlene Russeft, Philip D Dickison, Roger LevineAbstract:This study examines the relationship between certification examination test results and Emergency Medical Technician (EMT) career success. The sample was drawn from the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). LEADS participants were matched with National Registry of Emergency Medical Technician (NREMT) certification testing data: (1) exam scores for each attempt until passing the exam, and (2) total number of attempts to pass the exam. Career success was measured both objectively and subjectively.
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instructor quality affecting Emergency Medical Technician emt preparedness a leads project
International Journal of Training and Development, 2005Co-Authors: Darlene Russeft, Philip D Dickison, Roger LevineAbstract:This represents one of a series of studies of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS) being undertaken by the National Registry of Emergency Medical Technicians and the National Highway Traffic Safety Administration (NHTSA). This secondary analysis of the LEADS database, which provides a representative sampling of EMTs throughout the United States, examines the effects of instructor quality on the level of preparedness of Emergency Medical Technicians (EMTs). Results showed significant differences, based on instructor quality, in the ratings on ten dimensions of EMT preparedness for both EMT Basics and EMT Paramedics. Implications for HRD practitioners, adult educators and researchers are discussed.
Chih Hao Lin - One of the best experts on this subject based on the ideXlab platform.
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impacts of Emergency Medical Technician configurations on outcomes of patients with out of hospital cardiac arrest
International Journal of Environmental Research and Public Health, 2020Co-Authors: Pin Hui Fang, Yu Yuan Lin, Ching Chi Lee, Chih Hao LinAbstract:Paramedics can provide advanced life support (ALS) for patients with out-of-hospital cardiac arrest (OHCA). However, the impact of Emergency Medical Technician (EMT) configuration on their outcomes remains debated. A three-year cohort study consisted of non-traumatic OHCA adults transported by ALS teams was retrospectively conducted in Tainan City using an Utstein-style population database. The EMT-paramedic (EMT-P) ratio was defined as the EMT-P proportion out of all on-scene EMTs. Among the 1357 eligible cases, the median (interquartile range) number of on-scene EMTs and the EMT-P ratio were 2 (2-2) persons and 50% (50%-100%), respectively. The multivariate analysis identified five independent predictors of sustained return of spontaneous circulation (ROSC): younger adults, witnessed cardiac arrest, prehospital ROSC, prehospital defibrillation, and comorbid diabetes mellitus. After adjustment, every 10% increase in the EMT-P ratio was on average associated with an 8% increased chance (adjusted odds ratio [aOR], 1.08; p < 0.01) of sustained ROSC and a 12% increase change (aOR, 1.12; p = 0.048) of favorable neurologic status at discharge. However, increased number of on-scene EMTs was not linked to better outcomes. For nontraumatic OHCA adults, an increase in the on-scene EMT-P ratio resulted in a higher proportion of improved patient outcomes.
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comparison of Emergency Medical services systems across pan asian countries a web based survey
Prehospital Emergency Care, 2012Co-Authors: Sang Do Shin, Chih Hao Lin, Marcus Eng Hock Ong, Hideharu Tanaka, Matthew Hueiming, Tatsuya Nishiuchi, Omer Alsakaf, Sarah Abdul Karim, Nalinas Khunkhlai, Kyoung Jun SongAbstract:AbstractBackground. There are great variations in out-of-hospital cardiac arrest (OHCA) survival outcomes among different countries and different Emergency Medical services (EMS) systems. The impact of different systems and their contribution to enhanced survival are poorly understood. This paper compares the EMS systems of several Asian sites making up the Pan-Asian Resuscitation Outcomes Study (PAROS) network. Some preliminary cardiac arrest outcomes are also reported. Methods. This is a cross-sectional descriptive survey study addressing population demographics, service levels, provider characteristics, system operations, budget and finance, Medical direction (leadership), and oversight. Results. Most of the systems are single-tiered. Fire-based EMS systems are predominant. Bangkok and Kuala Lumpur have hospital-based systems. Service level is relatively low, from basic to intermediate in most of the communities. Korea, Japan, Singapore, and Bangkok have intermediate Emergency Medical Technician (EMT) ...
Matthew C Strehlow - One of the best experts on this subject based on the ideXlab platform.
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development and implementation of a novel web based gaming application to enhance Emergency Medical Technician knowledge in low and middle income countries
AEM education and training, 2021Co-Authors: Benjamin Lindquist, Matthew C Strehlow, Shivani Mathur Gaiha, Arjun Vasudevan, Sean Dooher, William J Leggio, William Mulkerin, Alexander Zozula, Stefanie S Seboksyer, Swaminatha V MahadevanAbstract:Background Increasing access to high-quality Emergency and prehospital care is an important priority in low- and middle-income countries (LMICs). However, ensuring that Emergency Medical Technicians (EMTs) maintain their clinical knowledge and proficiency with procedural skills is challenging, as continuing education requirements are still being introduced, and clinical instructional efforts need strengthening. We describe the development and implementation of an innovative asynchronous learning tool for EMTs in the form of a Web-based trivia game. Methods Over 500 case-based multiple-choice questions (covering 10 essential prehospital content areas) were created by experts in prehospital education, piloted with EMT educators from LMICs, and delivered to EMTs through a Web-based quiz game platform over a 12-week period. We enrolled 252 participants from nine countries. Results Thirty-two participants (12.7%) completed the entire 12-week game. Participants who completed the game were administered a survey with a 100% response rate. Ninety-three percent of participants used their mobile phone to access the game. Overall, participants reported that the interface was easy to use (93.8% agreed or strongly agreed), the game improved their knowledge (100% agreed or strongly agreed), and they felt better prepared for their jobs (100% agreed or strongly agreed). The primary motivators for participation were improving patient care (37.5%) and being recognized on the game's leaderboard (31.3%). All participants reported that they would engage in the game again (43.8% agreed and 56.3% strongly agreed) and would recommend the game to their colleagues (34.4% agreed and 65.6% strongly agreed). Conclusions In conclusion, a quiz game targeting EMT learners from LMICs was viewed as accessible and effective by participants. Future efforts should focus on increasing retention and trialing languages in addition to English.
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first look at Emergency Medical Technician wellness in india application of the maslach burnout inventory in an unstudied population
PLOS ONE, 2020Co-Authors: Kathryn W Koval, Matthew C Strehlow, Benjamin Lindquist, Christine Gennosa, Aditya Mahadevan, Kian Niknam, Sanket Patil, G Ramana V Rao, Jennifer A NewberryAbstract:Introduction Professional wellness is critical to developing and maintaining a health care workforce. Previous work has identified burnout as a significant challenge to professional wellness facing Emergency Medical Technicians (EMTs) in many countries worldwide. Our study fills a critical gap by assessing the prevalence of burnout among Emergency Medical Technicians (EMTs) in India. Methods This was a cross-sectional survey of EMTs within the largest prehospital care organization in India. We used the Maslach Burnout Inventory (MBI) to measure wellness. All EMTs presenting for continuing Medical education between July-November 2017 from the states of Gujarat, Karnataka, and Telangana were eligible. Trained, independent staff administered anonymous MBI-Medical Personnel Surveys in local languages. Results Of the 327 EMTs eligible, 314 (96%) consented to participate, and 296 (94%) surveys were scorable. The prevalence of burnout was 28.7%. Compared to EMTs in other countries, Indian EMTs had higher levels of personal accomplishment but also higher levels of emotional exhaustion and moderate levels of depersonalization. In multivariate regression, determinants of burnout included younger age, perceived lack of respect from colleagues and administrators, and a sense of physical risk. EMTs who experienced burnout were four times as likely to plan to quit their jobs within one year. Conclusion This is the first assessment of burnout in EMTs in India and adds to the limited body of literature among low- and middle-income country (LMIC) prehospital providers worldwide. Burnout was strongly associated with an EMT’s intention to quit within a year, with potential implications for employee turnover and healthcare workforce shortages. Burnout should be a key focus of further study and possible intervention to achieve internationally recognized targets, including Sustainable Development Goal 3C and WHO’s 2030 Milestone for Human Resources.
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characteristics and outcomes of women using Emergency Medical services for third trimester pregnancy related problems in india a prospective observational study
BMJ Open, 2016Co-Authors: Matthew C Strehlow, Jennifer A Newberry, Corey B Bills, Elizabeth Pirrotta, Ann Evensen, Lawrence Leeman, S V MahadevanAbstract:Objectives Characterise the demographics, management and outcomes of obstetric patients transported by Emergency Medical services (EMS). Design Prospective observational study. Setting Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. Participants This study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a ‘pregnancy-related’ problem for free-of-charge ambulance transport. Calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival and patients refusing care were excluded. Main outcome measures Emergency Medical Technician (EMT) interventions, method of delivery and death. Results The median age enrolled was 23 years (IQR 21–25). Women were primarily from rural or tribal areas (1550/1684 (92.0%)) and lower economic strata (1177/1684 (69.9%)). Time from initial call to hospital arrival was longer for rural/tribal compared with urban patients (66 min (IQR 51–84) vs 56 min (IQR 42–73), respectively, p Conclusions Pregnant women from vulnerable Indian populations use free-of-charge EMS for impending delivery, making it integral to the healthcare system. Future research and health system planning should focus on strengthening and expanding EMS as a component of Emergency obstetric and newborn care (EmONC).
S V Mahadevan - One of the best experts on this subject based on the ideXlab platform.
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characteristics and outcomes of women using Emergency Medical services for third trimester pregnancy related problems in india a prospective observational study
BMJ Open, 2016Co-Authors: Matthew C Strehlow, Jennifer A Newberry, Corey B Bills, Elizabeth Pirrotta, Ann Evensen, Lawrence Leeman, S V MahadevanAbstract:Objectives Characterise the demographics, management and outcomes of obstetric patients transported by Emergency Medical services (EMS). Design Prospective observational study. Setting Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. Participants This study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a ‘pregnancy-related’ problem for free-of-charge ambulance transport. Calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival and patients refusing care were excluded. Main outcome measures Emergency Medical Technician (EMT) interventions, method of delivery and death. Results The median age enrolled was 23 years (IQR 21–25). Women were primarily from rural or tribal areas (1550/1684 (92.0%)) and lower economic strata (1177/1684 (69.9%)). Time from initial call to hospital arrival was longer for rural/tribal compared with urban patients (66 min (IQR 51–84) vs 56 min (IQR 42–73), respectively, p Conclusions Pregnant women from vulnerable Indian populations use free-of-charge EMS for impending delivery, making it integral to the healthcare system. Future research and health system planning should focus on strengthening and expanding EMS as a component of Emergency obstetric and newborn care (EmONC).
Ching Chi Lee - One of the best experts on this subject based on the ideXlab platform.
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impacts of Emergency Medical Technician configurations on outcomes of patients with out of hospital cardiac arrest
International Journal of Environmental Research and Public Health, 2020Co-Authors: Pin Hui Fang, Yu Yuan Lin, Ching Chi Lee, Chih Hao LinAbstract:Paramedics can provide advanced life support (ALS) for patients with out-of-hospital cardiac arrest (OHCA). However, the impact of Emergency Medical Technician (EMT) configuration on their outcomes remains debated. A three-year cohort study consisted of non-traumatic OHCA adults transported by ALS teams was retrospectively conducted in Tainan City using an Utstein-style population database. The EMT-paramedic (EMT-P) ratio was defined as the EMT-P proportion out of all on-scene EMTs. Among the 1357 eligible cases, the median (interquartile range) number of on-scene EMTs and the EMT-P ratio were 2 (2-2) persons and 50% (50%-100%), respectively. The multivariate analysis identified five independent predictors of sustained return of spontaneous circulation (ROSC): younger adults, witnessed cardiac arrest, prehospital ROSC, prehospital defibrillation, and comorbid diabetes mellitus. After adjustment, every 10% increase in the EMT-P ratio was on average associated with an 8% increased chance (adjusted odds ratio [aOR], 1.08; p < 0.01) of sustained ROSC and a 12% increase change (aOR, 1.12; p = 0.048) of favorable neurologic status at discharge. However, increased number of on-scene EMTs was not linked to better outcomes. For nontraumatic OHCA adults, an increase in the on-scene EMT-P ratio resulted in a higher proportion of improved patient outcomes.