Open Access Emergency Medicine (May 2022)
Emergency Medical Services Prehospital Response to the COVID-19 Pandemic in the US: A Brief Literature Review
Abstract
Christian Angelo I Ventura,1– 3 Edward E Denton,3– 5 Jessica Anastacia David,6 Brianna J Schoenfelder,7 Lillian Mela,8 Rebecca P Lumia,9 Rachel B Rudi,3 Barnita Haldar3,10 1Department of Graduate Medical Sciences, Boston University School of Medicine Boston, Boston, MA, USA; 2Department of Health, Behavior and Society (Incoming), Johns Hopkins Bloomberg School of Public Health Baltimore, Baltimore, MD, USA; 3EMS Pandemic Response Research Laboratory Lawrenceville, Lawrenceville, NJ, USA; 4Department of Emergency Medicine, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR, USA; 5Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR, USA; 6Department of Biochemistry and Microbiology, Rutgers University New Brunswick, Brunswick, NJ, USA; 7Department of Neuroscience, Temple University Philadelphia, Philadelphia, PA, USA; 8Department of Nursing, Simmons University Boston, Boston, MA, USA; 9Department of Biology, Northeastern University Boston, Boston, MA, USA; 10Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham School of Medicine Birmingham, Birmingham, AL, USACorrespondence: Christian Angelo I Ventura, Tel +1 (732) 372-2141, Email [email protected]; [email protected]: This study aimed to analyze prehospital Emergency Medical Services (EMS) response to the COVID-19 pandemic in the US through a brief systematic review of available literature in context with international prehospital counterparts. An exploration of the NCBI repository was performed using a search string of relevant keywords which returned n=5128 results; articles that met the inclusion criteria (n=77) were reviewed and analyzed in accordance with PRISMA and PROSPERO recommendations. Methodical quality was assessed using critical appraisal tools, and the Egger’s test was used for risk of bias reduction upon linear regression analysis of a funnel plot. Sources of heterogeneity as defined by P 50% were interrogated. Findings were considered within ten domains: structural/systemic; clinical outcomes; clinical assessment; treatment; special populations; dispatch/activation; education; mental health; perspectives/experiences; and transport. Findings suggest, EMS clinicians have likely made significant and unmeasured contributions to care during the pandemic via nontraditional roles, ie, COVID-19 testing and vaccine deployment. EMS plays a critical role in counteracting the COVID-19 pandemic in addition to the worsening opioid epidemic, both of which disproportionately impact patients of color. As such, being uniquely influential on clinical outcomes, these providers may benefit from standardized education on care and access disparities such as racial identity. Access to distance learning continuing education opportunities may increase rates of provider recertification. Additionally, there is a high prevalence of vaccine hesitancy among surveyed nationally registered EMS providers. Continued rigorous investigation on the impact of COVID-19 on EMS systems and personnel is warranted to ensure informed preparation for future pandemic and infectious disease responses.Keywords: EMS, COVID-19, prehospital, pandemic response, EMT, paramedic
