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EFIC Paramedic Attitude Survey

This study conducted by Dr. R. Daniel Bledsoe, Associate Medical Director of WellSpan EMS, explores paramedic attitudes towards the Exception from Informed Consent (EFIC) approach. With 55 respondents averaging 17 years of experience, the survey reveals important insights into EMS culture, formal and informal hierarchies, and the decision-making process regarding patient enrollment. Despite a minority expressing reservations about EFIC, most paramedics felt that medical necessity outweighed personal objections. The results underscore the need for paramedic involvement in future EFIC research planning.

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EFIC Paramedic Attitude Survey

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  1. EFIC Paramedic Attitude Survey R. Daniel Bledsoe, MD, FACEP Associate Medical Director, WellSpan EMS Director, Section of Prehospital Care & Disaster Medicine York Hospital Emergency Medicine Residency Program

  2. What we think is obvious…

  3. EMS Culture • Paramilitary • Formal and Informal hierarchy • A lot of sharing with the fire service • “You said it, Lou.” • Protocol driven patient care

  4. Community Consultation • Civic groups • Houses of worship • Patient support/disease management groups • Hours of time asking potential patients

  5. What do paramedics think about EFIC? • We want to think they would like it… • But we want to think people wouldn’t • Eat the Silica Gel in packaging, too. • Place an RV in cruise control and go into the back • Etc. • Etc.

  6. Highlights • Anonymous survey • Exempted by Wellspan Health’s Medical/Surgical IRB • Focus group cognitive testing for validity • Could not both track and maintain agency anonymity (a condition of distribution) • Emailed with opportunity to enter incentive drawing ($50 gift cards) • 55 respondents with an average of nearly 17 years experience

  7. Respondents • Most responded over a year after study training

  8. Have YOU enrolled a patient?

  9. Would you enroll an eligible pt?

  10. When should a medic enroll??

  11. Autonomy vs. Societal Benefit

  12. Conclusions • This is a small, pilot study • A distinct minority of paramedics surveyed had reservations about enrolling under EFIC • A majority felt medics should enroll over personal objections • Generalizable and further research is needed • Field paramedics should be part of planning field EMS EFIC research

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