Emergency, prehospital & transport medicine

The department of emergency services at Sunnybrook Research Institute (SRI) is made up of several interdisciplinary teams committed to advancing patient care and improving individual and public health. Their areas of focus include the following:

• clinical and health services research focused on prehospital care;
• the emergency care of older people;
• prevention of delirium; and
• implementation science.

Current projects include the Paramedics assessing Elders at Risk for Independence Loss (PERIL) study and the Enabling Teamwork, Interprofessional Collaboration and Education (EnTICE) project. The PERIL study is an observational study on paramedics assessing elderly people at risk for independence loss, with an aim of identifying seniors at high risk for harmful outcomes after an encounter with emergency medical services (EMS). The EnTICE project aims to create a best-practices, evidence-based toolkit that will be useful for frontline critical care and emergency department teams, and help improve specific patient outcomes.

Care for acutely ill patients begins while they are in an ambulance or a helicopter—long before they reach the hospital. Research begins there, too.

The Prehospital and Transport Medicine Research Program is the largest of its kind in Canada. It has a relationship with prehospital providers from six regions in southern Ontario, and is affiliated with 43 Canadian academic and community hospitals. Research spans several areas.

Through strong collaborations with regional emergency medical services and the Sunnybrook Centre for Prehospital Medicine, researchers at SRI are working to determine the best strategy for classifying heart attack patients diagnosed by paramedics according to the urgency of their need for care. They will be comparing a strategy of using a clot-busting medication immediately given by paramedics in the home, versus a strategy of rapid transport directly to a specialized cardiac centre for a procedure to physically open the blocked artery with a catheter.

Early, high-quality chest compressions (cardiopulmonary resuscitation or CPR) performed by bystanders increase the chances of survival after sudden cardiac arrest. SRI researchers are studying barriers to laypeople performing CPR in the prehospital setting and exploring solutions to these barriers.  They are focusing on ways to improve CPR instructions given over the phone by 911 operators while emergency medical services are dispatched.  

Researchers in emergency medicine, in collaboration with the Institute for Clinical Evaluative Sciences, which is located on the Sunnybrook campus, are also working to identify the explanations for delays in emergency care, techniques to reduce wait times and tools to deploy emergency resources more efficiently.

Other research projects include the following:

• identifying the best electrical waveforms for defibrillating cardiac arrest patients; and
• developing tools to know when to stop resuscitation.

For more information, visit the department of emergency services or the Centre for Prehospital Medicine web site .