“The emergency department (ED) visit rate for older patients exceeds that of all age groups other than infants. The aging population will increase elder ED patient utilization to 35% to 60% of all visits. Older patients can have complex clinical presentations and be resource-intensive. Evidence indicates that emergency physicians fail to provide consistent high-quality care for elder ED patients, resulting in poor clinical outcomes.” This sobering evidence comes from the recently published paper - Development of Geriatric Competencies for Emergency Medicine Residents Using an Expert Consensus Process (Academic Emergency Medicine, 2010; 17:316324). This focus on the training of ED physicians in the care of older adult patients should also extend to EMS and EMT personnel who are at the forefront of geriatric patient care in prehospital settings.

The University of Rochester’s Division of Prehospital Medicine has recognized that these first-responders receive relatively little training in geriatrics despite caring for a large number of older adults in the field. Through a grant from the Health Resources and Services Administration (HRSA), they created Continuing Mobile Education for EMS Providers - a video-based educational program that addresses the need for more "on-demand" educational opportunities for EMS practitioners. Although designed for EMS providers, this educational program, delivered through various video podcasts (vodcasts) can also serve as a comprehensive and informative resource for any health care provider who may not have familiarity with prehospital medicine.

The vodcasts are grouped into 9 blocks or topic areas: Communication, Polypharmacy, End of Life Issues, Assessment, Psychosocial Issues, Procedures, Safety and the Older Adult, Respiratory Issues in the Older Adult and Geriatric Trauma. Each block contains 4 vodcasts (approximately 10 minutes each), which focus on certain subjects within the topic area. For example, the Psychosocial Issues block contains segments that cover Elder Abuse and Elder Neglect, Psychology and Aging, Barriers to Transporting the Elderly, and Access to Social Services. The latest topic, Geriatric Trauma, includes Understanding Geriatric Trauma, Assessing the Geriatric Trauma Patient, Burns in the Older Adult and Motor Vehicle Collisions and the Older Adult

Each vodcast includes interviews with physicians, EMTs, paramedics, and patients, thus providing a full picture of care for older adult patients in the prehospital setting. EMS personnel relate actual stories of patient care in the field and describe what the viewer should watch for, such as glancing in the refrigerator to make sure it is well stocked with necessities, or reporting any evidence of abuse or neglect. The videos also cover interprofessional issues such as the type of information that should be reported to ED personnel or to a social worker. After watching all 4 episodes in the block, a learner can earn 1-hour CME credit by downloading and completing a quiz accessible through the link on the site.

The videos, which require QuickTime to view, are streamed in high resolution directly from the University of Rochester’s website, but are also available in low resolutions for slower Internet connections. As a third option, viewers may also watch the videos through the Rochester EMS channel on the YouTube website (youtube.com/RochesterEMS). Since the series is available through the YouTube service, you can click to subscribe in order to receive alerts when new episodes are available.  The video files can also be downloaded to your computer or any mobile device such as an iPod.

Although these are vodcasts, most of these videos do not require the viewer to watch constantly. The vodcasts show individuals discussing patients as well as highlighting important geriatric issues, punctuated at times with title slides of critical information. They could easily be downloaded to an iPod in the same way as regular audio podcasts, without losing the educational impact. The developers could have included scenarios or illustrative examples during the video podcasts to take full advantage of the potential of video podcasts as a method of content delivery. Another item for viewers to note is that the series was created at the University of Rochester, which means that some of the content is specific to New York State and viewers will have to research the specific laws and guidelines that apply in their own community. Aside from these minor issues, the series is a useful resource that fills a gap in the education of EMS providers.

For more information about the Continuing Mobile Education for EMS Providers at The University of Rochester, go to http://www.rochesterems.org or view this resource right now on POGOe!