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Hesitancy towards the coronavirus disease 2019 (COVID-19) vaccine has been a topic of considerable concern in recent months. Studies have reported hesitancy within the general population and specific facets of the health care system. Little evidence has been published about vaccine hesitancy among Emergency Medical Services (EMS) providers despite them having played a frontline role throughout the pandemic.
Methods:
A 27-question survey examining vaccination decisions and potential influencing factors among EMS providers was created and disseminated. Responses from providers who declined a COVID-19 vaccine were compared with responses from providers who did not decline a COVID-19 vaccine.
Results:
Across 166 respondents, 16% reported declining a COVID-19 vaccine. Providers who self-identified as men, providers who reported conservative or conservative-leaning beliefs, and providers surrounded by environments where the vaccine was discussed negatively or not encouraged are significantly more likely to decline a vaccine (P <.01). Providers who have declined a vaccine reported significantly greater levels of concern about its safety, effectiveness, and development (P <.01).
Conclusion:
This study answers key questions about why some EMS providers might be declining COVID-19 vaccinations. Initiatives to improve vaccination among EMS providers should focus on the areas highlighted, and further studies should continue to examine vaccine hesitancy among EMS providers as well as in other populations.
Evaluation of the headache patient begins with the historical exam. Physical findings of concern associated with the headache include: unequal weakness; generalized malaise and inability to ambulate; fevers; neck stiffness; and unequal pupils. Primary causes for the headache include tension headache, migraine, cluster and caffeine withdrawal, and the secondary causes include infection, subarachnoid hemorrhage (SAH), eye complaints, and tumors. Secondary headache is tending to improve as underlying cause of the headache is treated. This chapter presents a review of the common treatment options for the management of headache in the EMS environment. These include inhaled oxygen, anti-emetics, opioids, nonsteroidal anti-inflammatory drugs (NSAIDS), and analgesics. EMS providers must have a heightened level of concern for the causes of headache requiring emergent treatment. The area of headache evaluation and management in the EMS environment needs further study.
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