Publications

Selected articles by Dr. Keith Wesley, MD, FACEP, FAEMS. These are his "Street Science: Conversations About EMS Research" columns in JEMS, co-written with Karen Wesley, NREMT-P. Each column reviews a published EMS study and offers practical commentary. The summaries below are our own; please read the original articles in JEMS.

1. Intubation Success. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, January 2017.

   Reviews a multisite EMS agency's retrospective analysis of about 200 prehospital intubation attempts and the factors tied to success, including glottic view, tube size and crew pairing. Dr. Wesley urges every agency to track its own airway data and use it to shape training, competency checks and protocols, and questions habitual tube-size choices carried over from the operating room.

2. EMS vs. Police Transport. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, February 2017.

   Examines research comparing survival of urban penetrating-trauma patients transported by police versus EMS. The commentary agrees rapid transport did not appear to worsen outcomes, while noting the data came mostly from a few cities, injury-to-ED times were not documented, and liability concerns limit adoption elsewhere.

3. Pediatric Pain. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, March 2017.

   Looks at a multi-agency effort to raise opioid administration for children in pain through protocol changes and mandatory education, which produced little change. The authors discuss likely barriers, including receiving-ED pushback, unreliable pediatric pain scales and the need for ongoing refresher training.

4. Vital Handoffs. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, May 2017.

   Discusses a study that audited whether the expected elements of the EMS-to-hospital patient handoff actually occurred. The column frames handoff as a two-way conversation and encourages both EMS crews and receiving staff to ask questions so nothing important is left out.

5. Age-Based Epi Delivery. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, June 2017.

   Reviews research on epinephrine use and cardiovascular complications in older versus younger adults with anaphylaxis. Dr. Wesley critiques the study's age-50 cutoff and missing cardiac risk-factor data, and warns against withholding lifesaving epinephrine from older patients out of unfounded fear.

6. Guidelines & Rules. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, July 2017.

   Analyzes Resuscitation Outcomes Consortium data on how well the Universal Termination of Resuscitation guideline predicts survival from cardiac arrest. The column supports applying the full guideline rather than transporting patients solely because return of spontaneous circulation was not achieved.

7. Phone a Physician. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, August 2017.

   Covers a mobile integrated healthcare program that used physician telemedicine consultation to help EMS safely triage patients who did not need ambulance transport to an ED. The authors highlight its low per-patient cost and argue that payers must reimburse such services for these programs to be sustainable.

8. Patient Satisfaction. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, September 2017.

   Reviews patient-satisfaction survey data from ambulance services across Australia, New Zealand and Papua New Guinea. The column draws lessons for U.S. agencies about the human side of care, such as explaining what you are doing and taking patient concerns seriously.

9. A Difficult Challenge. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, October 2017.

   Draws on qualitative research about family presence during resuscitation. The authors encourage providers to invite families to be present, communicate early and compassionately, and focus on the family's emotional needs rather than perceived liability.

10. Not Another Lift Assist!. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, December 2017.

    Discusses a Canadian EMS service's study of patients who received a lift assist without treatment or transport, a notable share of whom visited the ED within two weeks. The column argues lift-assist calls deserve a real assessment as a warning sign of underlying problems.

11. Sepsis Assessments. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, January 2018.

    Evaluates whether the qSOFA sepsis score, applied retrospectively to EMS records, could help identify sepsis in the field. Dr. Wesley is skeptical of its prehospital value, especially in elderly patients, and stresses a strong index of suspicion and good history taking.

12. A Lateral Move. Keith Wesley, MD & Karen Wesley, NREMT-P. JEMS, Street Science, February 2018.

    Examines research on lateral versus supine positioning for trauma patients with possible spinal injury. The column notes the airway risks of supine transport and how the findings relate to current NAEMSP spinal motion restriction guidance.