Simulating Teamwork for Better Decision Making in Pediatric Emergency Medical Services.

Emergency Medical Services (EMS) are an essential component of health systems and are critical to the provision of pediatric emergency care. Challenges in this setting include fast pace, need for advanced teamwork, situational awareness and limited resources. The purpose of this study was to identify human factors-related obstacles during care delivery by EMS teams that could lead to inefficiencies and patient safety issues. We examined video recordings of 24 simulations of EMS teams (paramedics and EMTs) who were providing care to pediatric patients. Two reviewers documented a total of 262 efficiency and patient safety issues in 4.25 hours of videos. These issues were grouped into 28 categories. Reviewers also documented 19 decision support opportunities. These issues and decision support opportunities can inform the design of clinical decision support systems that can improve EMS related patient outcomes.

Public Perceptions on Why Women Receive Less Bystander Cardiopulmonary Resuscitation Than Men in Out-of-Hospital Cardiac Arrest.

BACKGROUND: Women who suffer an out-of-hospital cardiac arrest receive bystander cardiopulmonary resuscitation (CPR) less often than men. Understanding public perceptions of why this occurs is a necessary first step toward equitable application of this potentially life-saving intervention. METHODS: We conducted a national survey of members of the public using Mechanical Turk, Amazon's crowdsourcing platform, to determine reasons why women might receive bystander CPR less often than men. Eligible participants were adults (≥18 years) located in the United States. Responses were excluded if the participant was not able to define CPR correctly. Participants were asked to answer the following free-text question: "Do you have any ideas on why women may be less likely to receive CPR than men when they collapse in public?" Descriptive statistics were used to define the cohort. The free-text response was coded using open coding, and major themes were identified via classical content analysis. RESULTS: In total, 548 subjects were surveyed. Mean age was 38.8 years, and 49.8% were female. Participants were geographically distributed as follows: 18.5% West, 9.2% Southwest, 22.0% Midwest, 27.5% Southeast, and 22.9% Northeast. After analysis, 3 major themes were detected for why the public perceives that women receive less bystander CPR. They include the following: (1) sexualization of women's bodies; (2) women are weak and frail and therefore prone to injury; and (3) misperceptions about women in acute medical distress. Overall, 41.9% (227) were trained in CPR while 4.4% reported having provided CPR in a medical emergency. CONCLUSIONS: Members of the general public perceive fears about inappropriate touching, accusations of sexual assault, and fear of causing injury as inhibiting bystander CPR for women. Educational and policy efforts to address these perceptions may reduce the sex differences in the application of bystander CPR.