{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T03:51:00Z","timestamp":1747194660337,"version":"3.40.5"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T00:00:00Z","timestamp":1633564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Limited research regarding administration of timed medication infusions in the prehospital environment has identified wide variability with accuracy, timing, and overall feasibility. This study was a quality improvement project that utilized a randomized, controlled, crossover study design to compare two different educational techniques for medication infusion administration. We hypothesized that the use of a metronome-based technique would decrease medication dosage errors and reduce time to administration for intravenous medication infusions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Forty-two nationally registered paramedics were randomized to either a metronome-based technique versus a standard stopwatch-based technique. Each subject served as a control. Subjects were asked to establish an infusion of amiodarone at a dose of 150\u2009mg administered over 10\u2009min, simulating treatment of a hemodynamically stable patient with sustained monomorphic ventricular tachycardia. Descriptive statistics and a repeated measures mixed linear regression model were used for data analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>When compared to a standard stopwatch-based technique, a metronome-based technique was associated with faster time to goal (median 34\u2009s [IQR, 22\u201354] vs 50\u2009s; [IQR 38\u201361\u2009s], <jats:italic>P<\/jats:italic>\u2009=\u20090.006) and fewer mid-infusion adjustments. Ease of use was reported to be significantly higher for the metronome group (median ranking 5, IQR 4\u20135) compared to the standard group (median ranking 2, IQR 2\u20133; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Knowledge regarding a metronome technique may help EMS clinicians provide safe and effective IV infusions. Such a technique may be beneficial for learners and educators alike.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12873-021-00503-6","type":"journal-article","created":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T10:23:19Z","timestamp":1633602199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of a metronome-guided prehospital medication infusion technique with standard calculation: a simulated randomized, controlled, cross-over study"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5563-4092","authenticated-orcid":false,"given":"Samuel M.","family":"Galvagno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Cloepin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie","family":"Hannas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurt S.","family":"Rubach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Naumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Wendell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,7]]},"reference":[{"key":"503_CR1","volume-title":"Paramedic Candidate Handbook","author":"National Registry of Emergency Medical Technicians","year":"2019","unstructured":"National Registry of Emergency Medical Technicians. Paramedic Candidate Handbook. Columbus: National Registry of Emergency Medical Technicians; 2019."},{"issue":"5","key":"503_CR2","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1080\/10903127.2018.1436208","volume":"22","author":"C Loner","year":"2018","unstructured":"Loner C, Acquisto NM, Lenhardt H, Sensenbach B, Purick J, Jones CMC, et al. Accuracy of intravenous infusion flow regulators in the prehospital environment. Prehosp Emerg Care. 2018;22(5):645\u20139. https:\/\/doi.org\/10.1080\/10903127.2018.1436208.","journal-title":"Prehosp Emerg Care"},{"issue":"1","key":"503_CR3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.3109\/10903127.2015.1051681","volume":"20","author":"PJ Coppler","year":"2016","unstructured":"Coppler PJ, Padmanabhan R, Martin-Gill C, Callaway CW, Yealy DM, Seymour CW. Accuracy of prehospital intravenous fluid volume measurement by emergency medical services. Prehosp Emerg Care. 2016;20(1):125\u201331. https:\/\/doi.org\/10.3109\/10903127.2015.1051681.","journal-title":"Prehosp Emerg Care"},{"issue":"5","key":"503_CR4","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1111\/1742-6723.13146","volume":"30","author":"CR Foerster","year":"2018","unstructured":"Foerster CR, Andrew E, Smith K, Bernard S. Amiodarone for sustained stable ventricular tachycardia in the prehospital setting. Emerg Med Australas. 2018;30(5):694\u20138. https:\/\/doi.org\/10.1111\/1742-6723.13146.","journal-title":"Emerg Med Australas"},{"key":"503_CR5","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.resuscitation.2017.10.012","volume":"121","author":"SL McLeod","year":"2017","unstructured":"McLeod SL, Brignardello-Petersen R, Worster A. Comparative effectiveness of antiarrhythmics for out-of-hospital cardiac arrest: a systematic review and network meta-analysis. Resuscitation. 2017;121:90\u20137. https:\/\/doi.org\/10.1016\/j.resuscitation.2017.10.012.","journal-title":"Resuscitation"},{"key":"503_CR6","doi-asserted-by":"publisher","first-page":"14378","DOI":"10.1136\/bmj.l4378","volume":"366","author":"K Dwan","year":"2019","unstructured":"Dwan K, Tianjing L, Altman DG, LElbourne D. CONSORT 2010 statement: extension to randomized crossover trials. BMJ. 2019;366:14378. https:\/\/doi.org\/10.1136\/bmj.l4378.","journal-title":"BMJ"},{"issue":"2","key":"503_CR7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/00031305.2016.1154108","volume":"70","author":"RLM Wasserstein","year":"2016","unstructured":"Wasserstein RLM, Lazar NA. The ASA\u2019s statement on P-values: context, process, and purpose. Am Stat. 2016;70(2):129\u201333. https:\/\/doi.org\/10.1080\/00031305.2016.1154108.","journal-title":"Am Stat"},{"issue":"7","key":"503_CR8","doi-asserted-by":"publisher","first-page":"e42","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.03.018","volume":"22","author":"G Asaithambi","year":"2013","unstructured":"Asaithambi G, Chaudhry SA, Hassan AE, Rodriguez GJ, Suri MF, Qureshi AI. Adherence to guidelines by emergency medical services during transport of stroke patients receiving intravenous thrombolytic infusion. J Stroke Cerebrovasc Dis. 2013;22(7):e42\u20135. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2012.03.018.","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"18","key":"503_CR9","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1056\/NEJMoa1514204","volume":"374","author":"PJ Kudenchuk","year":"2016","unstructured":"Kudenchuk PJ, Brown SP, Daya M, Rea T, Nichol G, Morrison LJ, et al. Amiodarone, lidocaine, or placebo for out-of-hospital cardiac arrest. N Engl J Med. 2016;374(18):1711\u201322. https:\/\/doi.org\/10.1056\/NEJMoa1514204.","journal-title":"N Engl J Med"},{"issue":"1","key":"503_CR10","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13049-020-0718-z","volume":"28","author":"DK Lee","year":"2020","unstructured":"Lee DK, Kim YJ, Kim G, Lee CA, Moon HJ, Oh J, et al. Correction to: impact of early intravenous amiodarone administration on neurological outcome in refractory ventricular fibrillation: retrospective analysis of prospectively collected prehospital data. Scand J Trauma Resusc Emerg Med. 2020;28(1):23. https:\/\/doi.org\/10.1186\/s13049-020-0718-z.","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"3","key":"503_CR11","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/ijn.12063","volume":"19","author":"K Park","year":"2013","unstructured":"Park K, Lee J, Kim S, Kim J, Kim I, Choi SP, et al. Infusion volume control and calculation using metronome and drop counter based intravenous infusion therapy helper. Int J Nurs Pract. 2013;19(3):257\u201364. https:\/\/doi.org\/10.1111\/ijn.12063.","journal-title":"Int J Nurs Pract"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00503-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12873-021-00503-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12873-021-00503-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,7]],"date-time":"2021-10-07T10:27:07Z","timestamp":1633602427000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcemergmed.biomedcentral.com\/articles\/10.1186\/s12873-021-00503-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,7]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["503"],"URL":"https:\/\/doi.org\/10.1186\/s12873-021-00503-6","relation":{},"ISSN":["1471-227X"],"issn-type":[{"type":"electronic","value":"1471-227X"}],"subject":[],"published":{"date-parts":[[2021,10,7]]},"assertion":[{"value":"31 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods were carried out in accordance with relevant guidelines from the University of Maryland School of Medicine (HP-00096185). This study was deemed exempt (not human subjects research) by the University of Maryland School of Medicine Institutional Review Board. Institutional review board oversight was not required under <i>45 CFR 46.104<\/i> as this work was a quality improvement project with the aim of determining an optimal educational technique for teaching paramedics. This was a simulation study that did not involve actual patients. Informed consent was not required for this study since participants were volunteers and no identifiable information was collected.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Dr. Galvagno reports personal fees from Northwest Anesthesia Seminars, grants from the Department of Defense, and is an employee of the United States Air Force Reserve. However, nothing in this work is related to this employment. The views expressed are those of the author and do not reflect the views of the US Air Force, the Department of Defense, or US Government.The remaining authors have no competing interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"111"}}