Preceptor: Reed Caldwell, MD, Lauryn Kosturko, MD
Contact: Reed Caldwell, MD, reed.caldwell@nyulangone.org
Tel: 212-263-1276

Prerequisite: None. This elective is open to both clerkship and post-clerkship students.

Description

Most American medical students do not have any exposure to emergency care in the prehospital environment during medical school, yet up to 88% of physicians report being called upon to respond to an emergency outside of the hospital environment. Administering medical care in the field brings a unique set of challenges – safety, limited assessment and intervention tools, and the need for patient transport to an appropriate facility – that many medical trainees have no experience grappling with during their training. Through EMS ride-along shifts, interactive didactic sessions, and interprofessional simulation experiences, this two-week elective will expose students to the challenges of delivering care outside of the controlled hospital setting, offer students a deeper view into specific patient circumstances that impact health, and help students foster strong interprofessional relationships with their allied health colleagues in EMS.

Objectives of the Elective

By the end of this two-week elective, students will:

1. Apply life-saving treatment algorithms used in the prehospital setting, with a particular focus on evidence-based responses to high-acuity patients in respiratory distress or shock.
2. Gain an appreciation for the challenges that are present when delivering medical care outside of a controlled setting.
3. Learn to cultivate strong inter-professional relationships between ED staff and prehospital providers.
4. Describe the systems in place for emergency medical response in New York City (from dialing 9-11 to arrival in the emergency department).
5. Understand how social determinants of health affect patients’ interactions with and need for emergency medical systems.
6. Recognize current areas of research in improving the quality of EMS care and critique recent EMS related research.
7. Understand the way EMS protocols are developed and updated, and how these processes differ across various EMS systems.
8. Understand and apply systems for coordinated response to mass casualty incidents.

Key Responsibilities of the student while on Elective

Attend three 12-hour and two 8-hour ambulance ride-along shifts.
Attend and actively participate in all didactic lectures and workshops.
Attend and actively participate in an interprofessional simulation.
Complete a final presentation, options are:

• Protocol Review: Pick an NYU Langone EMS protocol and review it based on EBM literature. “Cutting Edge” Exploration: Pick a “new frontier” in EMS (prehospital use of ultrasound, community paramedicine, Project ETHAN) and give a brief presentation on its use and evidence base.
• Case Presentation: on any interesting case seen in EMS ride time.

Total 70 hours over two weeks (35 hr/week)

Didactic Program

Two one-hour interprofessional case-based workshops on prehospital management of key high acuity emergencies: respiratory distress and shock.
ass Casualty Triage module and workshop.
Three one-hour EMS systems lectures/modules: Overview of NYC’s 9-11 Response System, Lifting and Moving Patients, and Emergency Medical Dispatch.
Two-hour journal club session.
Half-day interprofessional simulation.

Method of Evaluation

This is a pass/fail elective. Students will be evaluated based on their level of attendance and participation in didactics, engagement during ride-along shifts, and quality of their final presentation.

Scheduling Information

Months Offered: 2 weeks in March, May, August, October, and December
Report To: On the first day report to Greenberg Hall GBH 6G.
Students Per Period: 6
Duration: 2 weeks