Emergency medical services in Connecticut

Trends in demographic and employment characteristics of US emergency medical technicians and paramedics, 2011-2019

Background

Describing the US emergency medical services workforce is important to understand gaps in recruitment and retention and inform efforts to improve diversity. Our objective was to describe the characteristics and temporal trends of emergency medical technicians (EMTs) and paramedics in the United States.

Methods

We performed a repeated cross-sectional evaluation of US Census Bureau's American Community Survey 1-year Public Use Microdata Sample data sets from 2011-2019. We included respondents working as an EMT or paramedic. Survey-weighted descriptive statistics of demographic and employment characteristics were calculated. Trend analysis was conducted using joinpoint regression to estimate slope and annual percent change (APC).

Results

The total estimated number of EMTs and paramedics in the United States increased from 216,310 (95%CI 204,957-227,663) in 2011 to 289,830 (95%CI 276,918-302,743) in 2019 (APC 3.0%; 95%CI 1.4%, 4.7%). There was a slight increase in the proportion of females (2011, 31%; 2019, 35%). There was a significant decrease in proportion of non-Hispanic whites (2011, 80%; 2019, 72%; APC -1.5%; 95%CI -2.0%, -0.9%) with concurrent increases in other racial/ethnic groups (e.g., Hispanics, 2011, 10%; 2019, 13%). About half worked >40 hours per week, with little change over time. Between 15% and 18% lived and worked in different states, and about 40% traveled ≥30 minutes to their workplace.

Conclusions

The number of EMTs and paramedics actively working in EMS as their primary paid occupation has increased over time. However, there have been only modest changes in their demographic diversity.

Knowledge, training and willingness to perform bystander cardiopulmonary resuscitation among university students in Chongqing, China: a cross-sectional study

OBJECTIVE

To evaluate knowledge of cardiopulmonary resuscitation (CPR) among Chinese college students and their attitude towards participating in CPR training and willingness to perform bystander CPR.

DESIGN

A cross-sectional study.

PARTICIPANTS

A total of 1128 college students were selected through a multistage stratified random sampling method from 12 universities in Chongqing, China.

PRIMARY AND SECONDARY OUTCOMES

Primary outcomes included CPR knowledge and willingness to participate in training and perform bystander CPR; secondary outcomes included CPR training experience and obstacles to training and performing CPR.

RESULTS

The average score on CPR knowledge was 2.078 (±1.342). Only 45.5% of the respondents were willing to participate in CPR training. Women, respondents who were postgraduate or above, with liberal arts as major and with high CPR knowledge level were more willing to participate in CPR training. A total of 47.2% of the respondents were willing to provide simple assistance, such as checking the consciousness and breathing of the patient and dialling 120 (medical emergency call). Only 34.1% indicated their willingness to perform bystander CPR on strangers. Perceived behavioural control, behavioural attitudes and subjective norms are positive predictors of willingness to provide bystander CPR.

CONCLUSIONS

CPR knowledge and training rate were low among Chongqing college students. Willingness to participate in training and perform bystander CPR was also low. Improving legislation, strengthening training programmes, incorporating CPR training into the school curriculum and reshaping the social and public culture of offering timely help to those in need are recommended strategies to improve bystander CPR performance.

The Danish prehospital emergency healthcare system and research possibilities

The emergency medical healthcare system outside hospital varies greatly across the globe - even within the western world. Within the last ten years, the demand for emergency medical service systems has increased, and the Danish emergency medical service system has undergone major changes.Therefore, we aimed to provide an updated description of the current Danish prehospital medical healthcare system.Since 2007, Denmark has been divided into five regions each responsible for health services, including the prehospital services. Each region may contract their own ambulance service providers. The Danish emergency medical services in general include ambulances, rapid response vehicles, mobile emergency care units and helicopter emergency medical services. All calls to the national emergency number, 1-1-2, are answered by the police, or the Copenhagen fire brigade, and since 2011 forwarded to an Emergency Medical Coordination Centre when the call relates to medical issues. At the Emergency Medical Coordination Centre, healthcare personnel assess the situation guided by the Danish Index for Emergency Care and determine the level of urgency of the situation, while technical personnel dispatch the appropriate medical emergency vehicles. In Denmark, all healthcare services, including emergency medical services are publicly funded and free of charge. In addition to emergency calls, other medical services are available for less urgent health problems around the clock. Prehospital personnel have since 2015 utilized a nationwide electronic prehospital medical record. The use of this prehospital medical record combined with Denmark's extensive registries, linkable by the unique civil registration number, enables new and unique possibilities to do high quality prehospital research, with complete patient follow-up.