Prehosp Emerg Care. 2022 Mar-Apr;26(2):212-222. doi: 10.1080/10903127.2020.1856985. Epub 2021 Jan 12.
: The EMS Practice Analysis provides a vision of current prehospital care by defining the work performed by EMS professionals. In this manuscript, we present the National Advanced Life Support (ALS) EMS Practice Analysis for the advanced EMT (AEMT) and paramedic levels of certification. The goal of the 2019 EMS Practice Analysis is to define the work performed by EMS professionals and present a new template for future practice analyses. The project was executed in three phases. Phase 1 defined the types/frequency of EMS clinical presentations using the 2016 National Emergency Medical Services Information System (NEMSIS) dataset. Phase 2 defined the criticality or potential for harm of these clinical presentations through a survey of a random sample of nationally certified EMS professionals and medical directors. Phase 3 defined the tasks and the associated knowledge, skills, and abilities (KSA) that encompass EMS care through focus groups of subject matter experts. In Phase 1, the most common EMS adult impressions were traumatic injury, abdominal pain/problems, respiratory distress/arrest, behavioral/psychiatric disorder, and syncope/fainting. The most common pediatric impressions were traumatic injury, behavioral/psychiatric disorder, respiratory distress/arrest, seizure, and abdominal pain/problems. Criticality was defined in Phase 2 with the highest risk of harm for adults being airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, or stroke/CVA. In comparison, pediatric patients presenting with airway obstruction, respiratory distress/arrest, cardiac arrest, hypovolemia/shock, allergic reaction, stroke/CVA, and inhalation injury had the highest potential for harm. Finally, in Phase 3, task statements were generated for both paramedic and AEMT certification levels. A total of 425 tasks and 1,734 KSAs were defined for the paramedic level and 405 tasks and 1,636 KSAs were defined for the AEMT level. The 2019 ALS Practice Analysis describes prehospital practice at the AEMT and paramedic levels. This approach allows for a detailed and robust evaluation of EMS care while focusing on each task conducted at each level of certification in EMS. The data can be leveraged to inform the scope of practice, educational standards, and assist in validating the ALS levels of the certification examination.
: 紧急医疗服务（EMS）实践分析通过定义 EMS 专业人员所执行的工作，提供了当前院前护理的愿景。在本文中，我们介绍了针对高级 EMT（AEMT）和医护人员认证水平的国家高级生命支持（ALS）EMS 实践分析。2019 年 EMS 实践分析的目标是定义 EMS 专业人员所执行的工作，并为未来的实践分析提供新的模板。该项目分三个阶段执行。第一阶段使用 2016 年国家紧急医疗服务信息系统（NEMSIS）数据集定义 EMS 临床表现的类型/频率。第二阶段通过对全国认证的 EMS 专业人员和医疗主任的随机样本进行调查，定义这些临床表现的关键性或潜在危害。第三阶段通过主题专家的焦点小组定义涵盖 EMS 护理的任务以及相关的知识、技能和能力（KSA）。在第一阶段，最常见的 EMS 成人印象是创伤性损伤、腹痛/问题、呼吸窘迫/骤停、行为/精神障碍和晕厥/晕倒。最常见的儿科印象是创伤性损伤、行为/精神障碍、呼吸窘迫/骤停、癫痫发作和腹痛/问题。第二阶段定义了关键性，成年人的最高风险是气道阻塞、呼吸窘迫/骤停、心脏骤停、低血容量/休克、过敏反应或中风/CVA。相比之下，出现气道阻塞、呼吸窘迫/骤停、心脏骤停、低血容量/休克、过敏反应、中风/CVA 和吸入性损伤的儿科患者的潜在危害最高。最后，在第三阶段，为医护人员和 AEMT 认证级别生成了任务陈述。共为医护人员认证级别定义了 425 项任务和 1734 项 KSA，为 AEMT 认证级别定义了 405 项任务和 1636 项 KSA。2019 年 ALS 实践分析描述了 AEMT 和医护人员水平的院前实践。这种方法允许对 EMS 护理进行详细和有力的评估，同时关注 EMS 认证每个级别所进行的每个任务。这些数据可用于告知实践范围、教育标准，并有助于验证 ALS 认证的水平。
