Pulsara Blog

On March 2, 2021, the U.S. Department of Health and Human Services released a report detailing trends in the utilization of Emergency Department services between 2009 and 2018. Between 2009 and 2016, ED rates slowly but steadily increased. During the COVID-19 pandemic, ED volume rates have trended down, but the number of people needing care has not changed. And during COVID surges, open beds have become a precious commodity. 

The increased demand on medical providers' time and resources has been met with a particularly intriguing solution involving a newer model of care: community paramedicine.

Editor's Note: The following content originally appeared on EMS1.com. Special thanks to our guest blogger, Drew Rinella for EMS1 BrandFocus. 

Specialty patients present unique challenges to EMS providers in the field. Whether it's a rare medical condition, an unusual medical device, or an unfamiliar treatment, specialized conditions will require different considerations from more routine calls. But don't worry; even if you aren't familiar with the patient's condition or device, there are some practices you can use to help minimize the degree of unfamiliarity and still provide top-notch care for your patient. 

Here are 10 things you need to know about caring for specialty patients and managing resources around their care.

2023 Editor's Update: Please note that, as reported by JEMS.com on 6/28/23, the federal government is ending the ET3 program. According to the Centers for Medicare & Medicaid Services, “This decision does not affect Model Participants’ participation in the Model through December 31, 2023.” Read the full article on JEMS for more details: ET3 Program Comes to an Abrupt End. Be advised that Mobile Integrated Healthcare and Community Paramedicine are separate initiatives and are unaffected by the ET3 program termination.

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Force Multiplier Patient Care: How EMS Leaders are Revolutionizing the Industry through ET3 Clinic Partner Agencies & Mobile Technology

What if you could keep hundreds of low-acuity patients a week from having to needlessly go to the emergency room? And what if, by doing so, you could reduce or eliminate the challenge of slow turnaround times, free up much-needed EMS and hospital resources, and help patients get the care they need faster, more affordably, and more efficiently?

Austin-Travis County EMS is doing just that. With a scalable system of care, they kept 434 low-acuity patients out of the hospital in just three weeks—rerouting them to faster and more appropriate care via the interconnected support of their ET3 clinic partner agency and the telehealth communications and logistics platform Pulsara.

Presented by Steve White, Commander of Texas’s Austin-Travis County EMS Collaborative Care Communication Center Initiative (C4), along with Dr. Carlos Navarro, Medical Director for Care Value Optimization, Austin market WellMed Medical Management, the speakers will share tangible takeaways and cutting-edge insights that you can apply to your own organization today.

It has been a rough eighteen months for all disciplines within healthcare. Since the start of the pandemic, call volumes have increased. More people need help. And yet, as the pandemic drags on, there are fewer and fewer providers still on the job. Emergency services organizations around the world are experiencing staffing shortages. Headline after headline after headline has demonstrated that the problem is both severe and widespread.

Many factors have contributed to staffing shortages in EMS across the United States, as well as ambulance services in the UK and Australia. These factors will need to be addressed soon. In the meantime, however, those still on the job are left looking for ways to continue providing care for their patients. Staffing shortages are hard enough but are made even worse for those left behind when the lack of providers starts to impact the level of care they can provide. 

Over the past year, telehealth became a favored tool in non-emergent care for helping clinicians treat patients from a distance. However, many EMS organizations are now discovering that leveraging telehealth as a part of normal practice can actually help save time, preserve resources, and increase the output of smaller crews. 

If you're struggling with staffing shortages, here are a few ways telehealth may be able to help you work with the resources you have. 

EDITOR'S NOTE: Special thanks to Colin Moravec for writing today's blog post. You can connect with him on LinkedIn. 

COVID-19 has brought about a lot of challenges and changes in the healthcare industry. EMS agencies are BUSY. They have been pushing themselves to the max supporting their communities and putting themselves in harm’s way to help their communities through the COVID-19 pandemic. 

EMS agencies embody the value of grit. They get the job done at all costs, regardless of obstacles. This value is what makes EMTs and paramedics unique. They stay cognizant of their role in the community and in the chain of medical care, and they execute their job faithfully, regardless of the environment. This value of gritty determination makes up the culture of many EMS agencies and EMT professionals. 

Organizational culture is “a pattern of shared basic assumptions learned by a group as it solves its problems.”¹ It's the shared beliefs and values established by leaders and then communicated and reinforced in the environment, which ultimately shape team member perceptions, behaviors, and understanding.

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, David Wright, MS, PA-C, NREMT-P, for EMS1 BrandFocus. 

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The most important initial care step is to stop the burning process, but it’s also critical to know how to identify the type of burn and estimate the total area affected to help select the most appropriate destination for the patient

You and your partner are responding to a 911 call. Dispatch informs you that your patient suffered a burn. There is no additional information available at this time because the caller is quite panicked.

Your mind starts to race – maybe it’s a child who pulled a hot pot of noodles on top of themselves, maybe it’s a teenager playing with gasoline, maybe it’s a firefighter who was battling a fire, maybe it’s a grandparent who fell on a space heater.

No matter the situation you find when you arrive on scene, there are a few basic principles that apply to all burn patients. Here are 10 things EMS providers need to know to better assess and treat burns.

Time is everything in time-sensitive emergencies. But you don’t need us to tell you that. 

You know that time is tissue. You know that every minute counts, and every minute impacts your patient’s outcome. It’s your job: care for the patient, stabilize them, and transport them to the next stage in their care journey as quickly as possible. 

So why does it sometimes feel like the system isn’t built to support that? 

Delays in care happen for many, many reasons, but they all boil down to one thing: communication. 

We have a lot of different communication technologies that do the job they were meant to do: radios, pagers, phones, and fax machines. But they don’t talk to each other. With every middleman a message travels through, it’s another delay for your patient. And when time is of the essence, it’s essential to make sure that the right information gets to the right person at the right time.

Make a plan for treating pediatric pain that includes managing unfamiliarity and stress in both the patient and their parents or caregivers

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, Jonathan Lee, for EMS1 BrandFocus. 

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The most complete definition of pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” (IASP). It is a highly complex and subjective condition in any patient.

With pediatrics, this complexity is intensified by the fact that paramedics don’t encounter pediatric patients as frequently, creating more unfamiliarity and stress. Challenges related to paramedic training and exposure to pediatrics often lead to myths and misconceptions. Here are 10 important things every provider should know about managing pain in children.

As a medic, you matter to your patients’ care. 

You are the first person on the scene. You are the first to see the patient, to assess them, and to decide what kind of treatment they need. You decide whether they need transport to the ED, or whether they are safe to stay at home. 

Your decisions guide and influence the rest of their care journey. 

For most medics, involvement with a patient’s case ends when they drop the patient off at the hospital. Most don’t receive any feedback on the patient’s case, how their treatment went, or what their outcome was. Only one in three EMS agencies reports having any access to electronic, patient-specific medical information.

But...you need this kind of feedback. (What gets tracked gets improved.)

EDITOR'S NOTE: Special thanks to Brett Lyle for writing today's blog post. You can connect with her on LinkedIn. 

Annual Celebrations Bring Us Together

National holidays bring people together. We spend time with friends, families, and neighbors. We unite in common celebrations. 

But this last year has been different. 

Unity

In healthcare, the word unity has taken on a much greater meaning in the wake of COVID-19. As the world buckled under the weight of a global pandemic and many retreated into isolation, healthcare providers pulled together and risked their own safety to serve others. Information was shared across borders to help each other navigate uncharted territory. 

We asked ourselves many important questions: Are we putting our needs aside for the health, safety, and security of the general population? Are we doing things for the greater good? Are we sacrificing the right things and for the right reasons?

Do you ever get tired of repeating yourself as you tell the same patient story multiple different times, to multiple different audiences?

You write on the back of your glove to keep track of what’s happening with your patient on scene and during transport. You deliver your report to the hospital via radio, to let them know what to expect when you arrive. You give an in-person inpatient report when you hand off the patient at the bedside, and you may also have to complete a leave-behind hand-written “short form.” And finally, you’ve got the patient care report that you complete afterward, within 24 hours of the case. 

That’s at least five different times you have to repeat the same basic information to update everyone who needs to be in the know. 

What if there was a better way? (Hint: there is!)

Large Vessel Occlusion (LVO) strokes are considered to be one of the most severe types of strokes. As with all other stroke types, rapid treatment is key. Mechanical thrombectomy is now the accepted standard of care for treating LVO, meaning that it's critical to take the patient to an interventional-capable facility as quickly as possible—even if that means taking them somewhere further away than the closest available hospital. Time is of the essence; are you up to speed on what to look for when assessing for LVO? 

The patient care report is one of the most crucial parts of a call. This is your chance to give the hospital a brief report about your patient and let them know that you're on your way, giving them time to prepare for your arrival. Typically, though, you have to deliver your report in the midst of a chaotic scene, and things are equally as hectic at the hospital. What information is essential to communicate to the hospital before arrival?

While it’s critical that EMS providers stay on top of the latest clinical skills for saving lives, it’s also important to look for ways to improve overall operations, especially as ongoing changes brought about by the COVID-19 pandemic continue to change the way EMS providers deliver care.

From our free eBook, learn 10 things you need to know about four key operational issues, including interagency cooperation, the expanding role of telehealth in EMS, and lessons learned from the COVID-19 pandemic. We also explore how new innovations in your EMS station can help prepare providers to deliver the best patient care possible, as well as promote the safety and well-being of EMS providers themselves.

As a medic, you never know what your next call could be. Of all healthcare providers, your job is often the most unpredictable. Some types of calls are much more straightforward than others...and sometimes, the ones you might have less experience on—such as pediatric or OB-GYN calls—can be nerve-wracking. How do you turn the calls that scare you into calls you feel confident heading into? 

Pulsara's Vice President - Medical OPS, Brandon Means, teamed up with EMS1 to produce an original video series of critical paramedicine tips and techniques, called Progressive Paramedic. In this week's video and blog post, we throwback to Brandon's paramedic days as he reviews the three reasons why it's important to be a lifelong learner in EMS. Check it out below!

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author,  Marianne Meyers, BS, for EMS1 BrandFocus. 

EDITOR'S UPDATE: The ET3 program is mentioned throughout the below article. Please note that, as reported by JEMS.com on 6/28/23, the federal government is ending the ET3 program. According to the Centers for Medicare & Medicaid Services, “This decision does not affect Model Participants’ participation in the Model through December 31, 2023.” Read the full article on JEMS for more details: ET3 Program Comes to an Abrupt End. Be advised that Mobile Integrated Healthcare and Community Paramedicine are separate initiatives and are unaffected by the ET3 program termination.