Case Studies and Publications

How Metropolitan EMS and Baptist Health Medical Center worked together to achieve a remarkable outcome for one stroke patient. When a woman in Little Rock, Arkansas, began showing signs of a severe stroke on her birthday, what followed was a powerful example of how early recognition, coordinated teamwork, and real-time communication can lead to an extraordinary outcome. In this case, the system worked exactly as it should, and the results left even seasoned caregivers impressed.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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Metropolitan EMS in Little Rock, Arkansas, began using Pulsara to improve communication around behavioral health cases. Over a span of eight months, MEMS achieved a 44% reduction in pediatric mental health patients transported to the ED—and instead, transporting them directly to behavioral health facilities.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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Severely injured patients often depend on prompt prehospital triage for survival. This study aimed to examine the undertriage of preventable or potentially preventable traumatic deaths. A retrospective review of Harris County, TX, revealed 1848 deaths within 24 hours of injury, with 186 being preventable or potentially preventable (P/PP). The analysis evaluated the geospatial relationship between each death and the receiving hospital. Out of the 186 P/PP deaths, these were more commonly male, minority, and penetrating mechanisms when compared with NP deaths. Of the 186 PP/P, 97 patients were transported to hospital care, 35 (36%) were transported to Level III, IV, or non-designated hospitals. Geospatial analysis revealed an association between the location of initial injury and proximity to receiving Level III, IV, and non-designated centers. Geospatial analysis supports proximity to the nearest hospital as one of the primary reasons for under-triage

Publication Contact at MEMS:

Jeff Tabor

jeff.tabor@metroems.org

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The Arkansas Trauma System was established by law more than a dozen years ago, and all participating trauma centers are required to maintain red blood cells. Since then, there has been a paradigm shift in resuscitating exsanguinating trauma patients. Damage Control Resuscitation with balanced blood products (or whole blood) and minimal crystalloid is now the standard of care. This project aimed to determine access to balanced blood products in our state’s Trauma System (TS).

Publication Contact at MEMS:

Jeff Tabor

jeff.tabor@metroems.org

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In cases of suspected stroke in prehospital patients, emergency medical services (EMS) response focuses on rapid assessment and transport. In Arkansas, stroke patients are identified by a unique barcode wristband for tracking and quality assurance.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

Chaundra Hegwood

chaundra.hegwood@metroems.org

Robert Trowbridge

robert.trowbridge@metroems.org

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The precision of emergency medical services (EMS) triage criteria dictates whether an injured patient receives appropriate care. The trauma triage protocol is a decision scheme that groups patients into triage categories of major, moderate and minor. We hypothesized that there is a difference between trauma triage category and injury severity score (ISS).

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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Survival after out-of-hospital cardiac arrest (OHCA) remains poor. A physiologically distinct cardiopulmonary resuscitation (CPR) strategy consisting of (1) active compression-decompression CPR and/or automated CPR, (2) an impedance threshold device, and (3) automated controlled elevation of the head and thorax (ACE) has been shown to improve neurological survival significantly versus conventional (C) CPR in animal models. This resuscitation device combination, termed ACE-CPR, is now used clinically.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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This project revolves around Emotional Responses in Emergency Medical Services(EMS). As in many Emergency Service Industries, emotions can run high. On the surface, those emotions would appear to revolve around the individual and the call they are responding to. However, some emotions go far beyond the specific 9-1-1 response. Approximately thirty percent of First Responders develop mental health disorders, including Acute Stress Disorder (ASD), depression, and post-traumatic stress disorder (PTSD), versus twenty percent of the general population (Langabeer et al., 2020). With EMS already being at increased risk, these agencies must take extra precautions with their workforce.

Publication Contact at MEMS:

John Woodward

john.woodward@metroems.org

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Purpose Psychological safety is key to efective debriefng and learning. The COVID-19 pandemic necessitated rapid adaption of simulation events to virtual/hybrid platforms. We sought to determine the efect of utilizing the Community of Inquiry framework (CoI) for debriefng virtually connecting interprofessional learner teams on the psychological safety experienced during trauma simulations

Publication Contact at MEMS:

Clayton Goddard

clayton.goddard@metroems.org

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Five years ago, when U.S. emergency docs first started talking about it, elevating the head as part of standard CPR was a tantalizingly simple possibility that looked like it might contribute to better outcomes. Five years later it’s part of a fleshed-out resuscitation bundle that’s been embraced in several major jurisdictions and may be starting to yield those hoped-for results.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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The coronavirus pandemic has overwhelmed the news in 2020, but it was measles that was making the headlines just one year earlier. Measles was eliminated from the US in the early 2000s [1], but outbreaks in early 2019 were a reminder that old beasts can come back, even with an effective vaccine.

Publication Contact at MEMS:

Mack Hutchison

mack.hutchison@metroems.org

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