Classical medical education teaches history and physical skills using scenarios wherein the criticality of a patient is predefined. This educational approach creates a gap in medical knowledge for students, who do not regularly define or establish patient criticality, and this gap is realized when it comes to the triage and management of critical patients. The purpose of this paper is to define an approach to patient assessment and management that is accessible to medical students regardless of criticality. This approach is algorithmic and defined by the use of three steps: (1) a primary survey, during which a general impression of the patient is formed, ABCDEs are assessed, and a criticality assessment is made; (2) a secondary survey, during which vitals, history, and exam data are all collected to form a working diagnosis; and (3) plan and treatment, during which supportive diagnostics, such as labs, imaging, and testing, are performed in the service of patient stabilization and intervention, consults/referrals are ordered/placed, and a final disposition is established. This model is intended to complement existing medical education and further expand it to encompass both critical and noncritical patients. 

Educational Recommendations for Medical Students Regarding Assessment and Management of Patients of Undifferentiated Criticality

This study aimed to evaluate three prehospital early warning scores (EWSs): RTS, MGAP and MREMS, to predict short-term mortality in acute life-threatening trauma and injury/illness by comparing United States (US) and Spanish cohorts. A total of 8854 patients, 8598/256 survivors/nonsurvivors, comprised the unified cohort. Datasets were randomly divided into training and test sets. Training sets were used to analyze the discriminative power of the scores in terms of the area under the curve (AUC), and the score performance was assessed in the test set in terms of sensitivity (SE), specificity (SP), accuracy (ACC) and balanced accuracy (BAC). The three scores showed great discriminative power with AUCs>0.90, and no significant differences between cohorts were found. In the test set, RTS/MREMS/MGAP showed SE/SP/ACC/BAC values of 86.0/89.9/89.6/87.1%, 91.0/86.9/87.5/88.5%, and 87.7/82.9/83.4/85.2%, respectively. All EWSs showed excellent ability to predict the risk of short-term mortality, independent of the country. 

Spanish vs USA cohort comparison of prehospital trauma scores to predict short-term mortality.

Biomechanical analysis of spinal misalignment during vehicular extrication maneuvers performed by professional rescue teams

Background
This study aimed to evaluate the effectiveness of a Pit Crew intervention to improve team dynamics and time to performance of critical actions in a prehospital critical care scenario. The primary outcome was successful completion of critical actions and time to completion of these critical actions. Secondary outcomes included effectiveness of communication and overall team functioning.


Methods
The study was conducted with a fire-based Emergency Medical Services (EMS) system with 233 paramedics and 115 Emergency Medical Technicians (EMT). Eight EMS crews comprised of five members each were randomly selected and assigned to either the intervention or the control group. The intervention group (n=20) watched a thirty-minute video prior to the training describing the "Pit Crew Approach;" the control group (n=20) did not watch the video. Each crew was given the same simulation scenario of a pediatric patient that had overdosed on a beta-blocker. Completion of predetermined critical tasks were noted and timestamped. A survey was administered to the participants following the training to assess team dynamics and level of confidence.


Results
Three outcomes were statistically significant between the two arms: The interventional group felt they themselves had a more defined role in the resuscitation in comparison to the non-interventional group (p= 0.021). The interventional group also felt that their team members had a clearer and more defined role than the nonintervention group (p= 0.018). The interventional group also felt more confident managing a beta blocker overdose than the nonintervention group (p.007). The only statistically significant secondary outcome finding was in scene departure decision: the interventional arm spent more time on-scene (p=0.031). Of note, the non-intervention group missed performing tasks more often than the interventional group and team leaders of these groups often performed task(s) while also directing the patient care.


Conclusion
The Pit Crew model was developed to optimize communication and team function. Our data identified that a formal instruction of the pit crew approach to a critical care scenario improved comfort in patient care. Future studies are needed evaluate other methods of training and the effects of continued formal pit-crew training over time.

The A to E (ABCDE) Pit Crew Model: A Novel Approach to Team Based Care of Critical Patients in the Prehospital Setting.

This study presents a unique way to provide simulation education to paramedics during the Coronavirus pandemic, without some of the logistical concerns that accompany traditional in-person simulation. Our county EMS personnel were divided in groups of 3-6 for the virtual simulation conducted by a physician facilitator who was remotely broadcasted to the EMS team performing tasks on a mannequin. A post-simulation survey was conducted to determine how the simulation affected their comfort level with managing respiratory failure in both suspected COVID-19 and non-COVID-19 patients. The 42 EMS personnel responding to the survey felt an increased comfort level in managing respiratory failure in a suspected or known COVID-19 patient after the virtual simulation. There was an increase in “extremely comfortable” responses from 24% to 43% before and after the simulation, and a decrease in “somewhat uncomfortable” responses from 10% to 0%. Respondents had extensive prior EMS experience, with 95% stating 2+ years working in EMS, and 33% with more than 10 year’s experience. Only 12% of the responders stated they underwent simulation training once a month or more, with 64% stating “a few times per year”. 86% of the responders felt the video platform was easy to use. The most common technical difficulty involved audio problems. EMS personnel undergoing a virtual simulation and debrief in the management of respiratory failure in the setting of the COVID-19 pandemic felt more comfortable in their management of these patients after their sessions. The majority recommended continuing this type of training in the future.

Impact of Virtual Simulation to Teach EMS Personnel Respiratory Failure Management During the COVID-19 Pandemic

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Parth Patel

Author Tools

Chat about Author

Papers

The A to E (ABCDE) Pit Crew Model: A Novel Approach to Team Based Care of Critical Patients in the Prehospital Setting.

Impact of Virtual Simulation to Teach EMS Personnel Respiratory Failure Management During the COVID-19 Pandemic