From Science to the Scene

Warning: this post contains discussion about suicide.

Addressing the mental health crisis in EMS requires moving beyond anecdotal accounts and examining concrete evidence. This important research evaluated state death records to explore suicide as a cause of death among prehospital personnel and the general public.
The findings reveal a particular vulnerability among younger EMS Clinicians. In the 18 to 34 age bracket, suicide accounted for 23.5% of all deaths among EMS Clinicians, compared to 16.4% in the general population. Overall, EMS Clinicians had 39% higher adjusted odds of death by suicide. These findings reinforce the importance of early recognition, active peer support, and open conversations about mental health across the EMS workforce. 

Read more: https://pubmed.ncbi.nlm.nih.gov/30136908/

Generalized, convulsive status epilepticus is a critical emergency where time and proper treatment matter immensely. In the latest episode of From Science to the Scene, Jacob breaks down a national study published in Annals of Emergency Medicine evaluating real-world midazolam use across 657 EMS agencies. National guidelines recommend a single 10 mg intramuscular (IM) injection for seizing adults, yet guideline-concordant care occurred in only 4.1% of the encounters. Most patients received lower doses via intravenous (IV) or intranasal (IN) routes.

Additionally, dosing and route directly impacted patient outcomes!

• Route: IN midazolam had the highest first dose failure rate frequently requiring rescue medication.
• Dose: Higher midazolam doses improved seizure control without increasing the need for ventilatory support.


For field Clinicians, these findings reinforce the risks of underdosing and show that decisive administration of 10 mg midazolam IM or rapid IV administration, if feasible, remain safe and highly effective vs IN delivery while on scene. 

Listen to the full podcast episode to learn how this research applies to your daily patient care. Read the complete published study here: https://www.annemergmed.com/article/S0196-0644(22)00363-8/fulltext

Emergency care in the prehospital setting is evolving rapidly, and staying informed on the latest evidence is essential for every practicing Clinician. In the newest episode of From Science to the Scene, Kayla breaks down the latest consensus guidance on stroke care to help you make critical decisions on the road.
This episode focuses on the practical application of stroke center designations and severity scales during rapid transport. Clinicians must quickly differentiate between lower and higher levels of stroke centers while using validated pre-hospital severity scales in the field. Accurately assessing stroke severity allows pre-hospital providers to direct patients to the most appropriate facility immediately, ensuring timely intervention when every minute counts.
Listen to the full episode to learn how applying these updated severity scales can refine your clinical practice and improve patient outcomes, and read the paper here: https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.033228

What if a single change in field protocols could double a patient's chances of surviving a severe brain injury? In this episode of From Science to the Scene, Research Director Ash Panchal breaks down ground-breaking statistical findings from The Excellence in Prehospital Injury Care (EPIC) Study.

The research analyzed thousands of real-world patient cases to measure the exact impact of standardized care. The data reveals a dramatic outcome. Adhering to clinical guidelines that prevent hypoxia, hypotension, and hyperventilation doubled survival for patients with severe injuries. Even more striking, the findings show a tripling of survival rates among patients who required endotracheal intubation.

This episode transforms complex data into practical knowledge for the entire emergency medical community. Field Clinicians will discover how simple adjustments directly save lives, while EMS leaders will gain the statistical evidence needed to drive system-wide protocol updates.

Listen to the full episode now to see how evidence-based research is actively reshaping emergency care.

Are your prehospital airway choices based on outdated tradition or true patient outcomes? In this episode of From Science to the Scene, host Chris Gage breaks down a ground-breaking evidence-based guideline that is reshaping how every Clinician approaches the airway. Discover why basic bag-valve-mask ventilation remains the core foundation of care and learn why supraglottic airways are often the smarter choice over endotracheal intubation. The episode also uncovers critical safety warnings regarding pediatric patients, emphasizing why lower procedural volume requires extreme caution. Most importantly, you will see how focusing on continuous waveform capnography and protecting patient blood pressure makes all the difference in successful resuscitation. Tune in now to elevate your practice and bring true science to your next shift.

Read the full evidence-based guideline study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2832116

What do you think is the most common injury leading to preventable death in civilian public mass shooting events? Many individuals might guess severe extremity bleeding, but the data tells a different story. 

On this episode of From Science to the Scene, Dr. Ash Panchal breaks down a critical study that every EMS Clinician needs to understand. The research looks closely at autopsy reports to find out what causes potentially preventable death in these terrible situations. The data reveals that civilian injuries are very different from military injuries, meaning our traditional response plans must adapt. 

Instead of the extremity wounds often seen on the battlefield, the vast majority of these civilian casualties suffer from hidden, non-hemorrhaging chest wounds, where a tension pneumothorax can quietly become fatal. Compounding this challenge, fewer than one in four of these individuals ever survive long enough to reach a hospital bed. This devastating reality proves that the windows of time for lifesaving medical intervention and rapid scene transport are overlapping and incredibly short. 

We must continue to learn how to improve our triage, care, and movement of patients in chaotic environments. Tune in to explore how the SALT mass casualty triage protocol helps us make a difference when every second counts.

 
Read the full study here: https://pubmed.ncbi.nlm.nih.gov/31029762/

Are you ready to transform how you approach trauma care on your next shift? 
In the latest episode of From Science to the Scene, Jacob unpacks how a single medication serves as a versatile powerhouse for pain management, procedural sedation, airway induction, and acute agitation. This discussion dives deep into the clinical utility and helps to shatter historical myths, noting that ketamine is safe for patients with head and eye injuries without causing harmful pressure spikes. You will learn why proper preparation is the true key to patient safety, from mastering weight-based pediatric dosing to setting up essential airway monitoring. 
Listen to the full episode now to elevate your clinical knowledge and bring the latest science to the scene!

Read the entire study here: https://www.tandfonline.com/doi/full/10.1080/10903127.2020.1801920

Did you know that layperson-administered naloxone (LAN) increased by over 43% in just two years? This week on From Science to the Scene, Jacob Kamholz discusses a major study that uses national EMS data to track how often the public intervenes during an overdose, before EMS arrives. While overall naloxone administration by EMS Clinicians actually decreased 6% over this period, the rise in LAN supports public health efforts and over-the-counter access initiatives aimed at getting this life-saving medication into the hands of the community, and the community is responding! The research notes that these interventions frequently occur in urban homes and residences, which are the very settings where rapid assistance is most critical. Check out the full episode to learn how EMS data is informing public health policy and highlighting community-led interventions.

Read the study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2824732

Should a Clinician "stay and play" or "load and go?" This question is at the heart of the latest episode of the From Science to the Scene podcast.

Our Research Fellow, Kayla Riel, joins the show to dive into a study that challenges old habits. For a long time, the common thought was that a fast trip to the hospital was the best chance for a patient in cardiac arrest. However, the latest data from the Journal of the American Medical Association tells a more complex story.

The research compares patients who were transported during resuscitation to those who received care on the scene. The results are clear: continuing care where the patient is found is linked to a higher rate of survival. A Clinician who focuses on high quality care on the scene may give their patient a better chance to return home to their family.

Moving a patient while their heart is not beating is a major challenge. It can lower the quality of chest compressions and create safety risks for the crew in the back of the ambulance. Kayla Riel explains how these findings should change the way we think about our protocols and our training.

See the research:
https://jamanetwork.com/journals/jama/fullarticle/2770622


#NREMT #EMS #EMT #cardiacarrest #ambulance #emergencymedicine #podcast #research

Are you ready to dive into the latest evidence on trauma care? In our fourth episode of "From Science to the Scene," we break down the STAAMP trial to see if pre-hospital administration of tranexamic acid (TXA) truly improves survival for patients at risk for hemorrhage. While the study found that pre-hospital TXA did not significantly lower the overall 30-day mortality rate, the data revealed critical benefits for specific groups. The results indicate that the Clinician can significantly impact outcomes by providing the medication within one hour of injury or to patients in severe shock. Furthermore, the study confirmed that pre-hospital TXA is safe and does not increase the risk of adverse events like blood clots or seizures. We invite you to explore how these findings might influence your practice or educational curriculum by listening to the full episode and reviewing the research today.

Read the full research paper here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2771225


#NREMT #EMS #EMT #paramedic #research #TXA #medical #healthcare #medicine #study #researcher #ambulance #emergency