New publication by students in UVM Medical Group course

Last year, the UVM Medical Group sponsored a new, intensive training program called “Introduction to clinical research using existing data.” Taught by faculty from the UVM College of Medicine, the course is designed for clinicians who want to develop their role as academic investigators by using the information available in PRISM, the clinical data warehouse, and other existing datasets to study medical and health care issues. Faculty included Charles D, MacLean, MDCM, Professor of Medicine and Associate Dean for Primary Care, Benjamin Littenberg, MD, Henry and Carleen Tufo Professor of Medicine and Professor of Nursing, Jeremy Fortune, MBA, Data Scientist, UVM Medical Center, Abigail Crocker, PhD, Assistant Professor of Mathematics and Statistics, and Valerie Harder, MHS, PhD, Assistant Professor of Pediatrics and Psychiatry. 

We're proud to announce that the first paper produced by the students has been published:

Daniel L. Wolfson MD, FACEP, Margaret A. Tandoh MD, FACS, Mohit Jindal MD, Patrick M. Forgione MD, FACS & Valerie S. Harder PhD, MHS (2016): Adult Intraosseous Access by Advanced EMTs: A Statewide Non-Inferiority Study, Prehospital Emergency Care, DOI:10.1080/10903127.2016.1209262

Objective: Intraosseous (IO) access is increasingly being used as an alternative to peripheral intravenous access, which is often difficult or impossible to establish in critically ill patients in the prehospital setting. Until recently, only Paramedics performed adult IO access. In 2014, Vermont Emergency Medical Services (EMS) expanded the Advanced Emergency Medical Technicians (AEMTs) scope of practice to include IO access in adult patients. This study compares successful IO access in adults performed by AEMTs compared to Paramedics in the prehospital setting.

Methods: All Vermont EMS patient encounters between January 1, 2013 and November 30, 2015 were examined, and 543 adult patients with a documented IO access insertion attempt were identified. The proportion of successful insertions was compared between AEMTs and Paramedics using a Chi-Squared statistic and a non-inferiority test.

Results: There was no significant difference in the percentage of successful IO access between AEMTs and Paramedics [95.2% and 95.6%, respectively; P = 0.84]. The confidence interval around this 0.4% difference (95% confidence interval = –4.2, 3.2) was within a pre-specified delta of ±10% indicating non-inferiority of AEMTs compared to Paramedics.

Conclusions: This study’s finding that successful IO access was not different among AEMTs and Paramedics lends evidence in support of expanding the scope of practice of AEMTs to include establishing IO access in adults. 

If you are interested in participating in next year's course (starting October 2016), contact Sylvie Frisbie at sylvie.frisbie@uvm.edu.