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Anjni Patel Joiner

Associate Professor of Emergency Medicine
Emergency Medicine
Box 3096 Med Ctr, Durham, NC 27710
2301 Erwin Road, Duke Hospital North, Box 3096, Durham, NC 27710

Selected Publications


Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.

Journal Article Circ Cardiovasc Qual Outcomes · April 2024 BACKGROUND: Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopu ... Full text Link to item Cite

Barriers and facilitators for developing a prehospital emergency care system evaluation tool (PEC-SET) for low-resource settings: a qualitative analysis.

Journal Article BMJ Open · December 9, 2023 OBJECTIVES: Strengthening of emergency care systems, including prehospital systems, can reduce death and disability. We aimed to identify perspectives on barriers and facilitators relating to the development and implementation of a prehospital emergency ca ... Full text Link to item Cite

AI-based approach for transcribing and classifying unstructured emergency call data: A methodological proposal.

Journal Article PLOS Digit Health · December 2023 Emergency care-sensitive conditions (ECSCs) require rapid identification and treatment and are responsible for over half of all deaths worldwide. Prehospital emergency care (PEC) can provide rapid treatment and access to definitive care for many ECSCs and ... Full text Link to item Cite

Built environment influence on the incidence of elderly pedestrian collisions in a medium-large city in southern Brazil: a spatial analysis.

Journal Article Int J Inj Contr Saf Promot · September 2023 Trauma disproportionately affects vulnerable road users, especially the elderly. We analyzed the spatial distribution of elderly pedestrians struck by vehicles in the urban area of Maringa city, from 2014 to 2018. Hotspots were obtained by kernel density e ... Full text Link to item Cite

A qualitative assessment of stakeholder perspectives on barriers and facilitators to emergency care delays in Northern Tanzania through the Three Delays.

Journal Article Afr J Emerg Med · September 2023 INTRODUCTION: Emergency conditions cause a significant burden of death and disability, particularly in developing countries. Prehospital and Emergency Medical Services (EMS) are largely nonexistent throughout Tanzania and little is known about the communit ... Full text Link to item Cite

Emergency unit capacity in Northern Tanzania: a cross-sectional survey.

Journal Article BMJ Open · February 22, 2023 INTRODUCTION: Emergency medicine (EM) is a growing field in Sub-Saharan Africa. Characterising the current capacity of hospitals to provide emergency care is important in identifying gaps and future directions of growth. This study aimed to characterise th ... Full text Link to item Cite

Shame and Guilt in EMS: A Qualitative Analysis of Culture and Attitudes in Prehospital Emergency Care.

Journal Article Prehosp Emerg Care · 2023 STUDY OBJECTIVES: The shame reaction is a highly negative emotional reaction shown to have long-term deleterious effects on the mental health of clinicians. Prior studies have focused on in-hospital personnel, but very little is known about what drives sha ... Full text Link to item Cite

Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review.

Journal Article Prehosp Emerg Care · 2023 OBJECTIVE: Emergency medical services (EMS) workforce demographics in the United States do not reflect the diversity of the population served. Despite some efforts by professional organizations to create a more representative workforce, little has changed ... Full text Open Access Link to item Cite

Predictors of Non-Transport for Older Adult EMS Patients Encountered for Falls.

Journal Article Prehosp Emerg Care · 2023 BACKGROUND: Emergency medical services (EMS) encounters for falls among older adults have been linked to poor outcomes when the patient is not transported by EMS to a hospital. However, little is known regarding characteristics of this patient population. ... Full text Link to item Cite

Disparities in Emergency Medical Services Care Delivery in the United States: A Scoping Review.

Journal Article Prehosp Emerg Care · 2023 BACKGROUND: Emergency medical services (EMS) often serve as the first medical contact for ill or injured patients, representing a critical access point to the health care delivery continuum. While a growing body of literature suggests inequities in care wi ... Full text Link to item Cite

The association of indoor heat exposure with diabetes and respiratory 9-1-1 calls through emergency medical dispatch and services documentation.

Journal Article Environ Res · September 2022 BACKGROUND: People with pre-existing medical conditions, who spend a large proportion of their time indoors, are at risk of emergent morbidities from elevated indoor heat exposures. In this study, indoor heat of structures wherein exposed people received G ... Full text Link to item Cite

Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest.

Journal Article Resuscitation · September 2022 AIM OF THE STUDY: While out-of-hospital cardiac arrest (OHCA) is associated with poor survival, early bystander CPR (B-CPR) and telephone CPR (T-CPR) improves survival from OHCA. American Heart Association (AHA) Scientific Statements outline recommendation ... Full text Link to item Cite

Medical transport-associated infection: Review and commentary making a case for its legitimacy.

Journal Article Infect Control Hosp Epidemiol · April 2022 The purpose of this article is to summarize existing literature about healthcare-associated infection (HAI) in the medical transport environment and to define the term medical transport-associated infection (MTAI) to unify all previous work under a single ... Full text Link to item Cite

Barriers to accessing follow up care in post-hospitalized trauma patients in Moshi, Tanzania: A mixed methods study.

Journal Article PLOS Glob Public Health · 2022 Disproportionately high injury rates in Sub-Saharan Africa combined with limited access to care in both the acute injury phase and for injury patients requiring continued care after hospital discharge remains a challenge. We aimed to characterize barriers ... Full text Link to item Cite

Emergency Care Sensitive Conditions in Brazil: A Geographic Information System Approach to Timely Hospital Access.

Journal Article Lancet Reg Health Am · December 2021 BACKGROUND: The benefits of treatment for many conditions are time dependent. The burden of these emergency care sensitive conditions (ECSCs) is especially high in low- and middle-income countries. Our objective was to analyze geospatial trends in ECSCs an ... Full text Link to item Cite

Global emergency medicine: A scoping review of the literature from 2020.

Journal Article Acad Emerg Med · November 2021 OBJECTIVE: The objective was to identify, screen, highlight, review, and summarize some of the most rigorously conducted and impactful original research (OR) and review articles (RE) in global emergency medicine (EM) published in 2020 in the peer-reviewed ... Full text Link to item Cite

Traumatic brain injury

Chapter · August 18, 2021 Traumatic brain injury (TBI) is a common cause of death and disability. Primary prevention is focused on injury prevention programs, education, and policies. Prehospital care is focused on rapid identification and prevention of secondary brain injury throu ... Full text Cite

A hypothetical implementation of 'Termination of Resuscitation' protocol for out-of-hospital cardiac arrest.

Journal Article Resusc Plus · June 2021 BACKGROUND: Out-of-hospital cardiac arrests with negligible chance of survival are routinely transported to hospital and many are pronounced dead thereafter. This leads to some potentially avoidable costs. The 'Termination of Resuscitation' protocol allows ... Full text Open Access Link to item Cite

The Role of Emergency Medical Services in the Opioid Epidemic.

Journal Article Prehosp Emerg Care · 2021 The opioid crisis is an ongoing public health concern and EMS agencies are in a critical position to reach at-risk populations. The traditional role of EMS in treating acute opioid overdoses has expanded to include preventative strategies as well as long-t ... Full text Link to item Cite

Incorporation of Drone Technology Into the Chain of Survival for OHCA: Estimation of Time Needed for Bystander Treatment of OHCA and CPR Performance.

Journal Article Circ Cardiovasc Qual Outcomes · April 2024 BACKGROUND: Drone-delivered automated external defibrillators (AEDs) hold promises in the treatment of out-of-hospital cardiac arrest. Our objective was to estimate the time needed to perform resuscitation with a drone-delivered AED and to measure cardiopu ... Full text Link to item Cite

Barriers and facilitators for developing a prehospital emergency care system evaluation tool (PEC-SET) for low-resource settings: a qualitative analysis.

Journal Article BMJ Open · December 9, 2023 OBJECTIVES: Strengthening of emergency care systems, including prehospital systems, can reduce death and disability. We aimed to identify perspectives on barriers and facilitators relating to the development and implementation of a prehospital emergency ca ... Full text Link to item Cite

AI-based approach for transcribing and classifying unstructured emergency call data: A methodological proposal.

Journal Article PLOS Digit Health · December 2023 Emergency care-sensitive conditions (ECSCs) require rapid identification and treatment and are responsible for over half of all deaths worldwide. Prehospital emergency care (PEC) can provide rapid treatment and access to definitive care for many ECSCs and ... Full text Link to item Cite

Built environment influence on the incidence of elderly pedestrian collisions in a medium-large city in southern Brazil: a spatial analysis.

Journal Article Int J Inj Contr Saf Promot · September 2023 Trauma disproportionately affects vulnerable road users, especially the elderly. We analyzed the spatial distribution of elderly pedestrians struck by vehicles in the urban area of Maringa city, from 2014 to 2018. Hotspots were obtained by kernel density e ... Full text Link to item Cite

A qualitative assessment of stakeholder perspectives on barriers and facilitators to emergency care delays in Northern Tanzania through the Three Delays.

Journal Article Afr J Emerg Med · September 2023 INTRODUCTION: Emergency conditions cause a significant burden of death and disability, particularly in developing countries. Prehospital and Emergency Medical Services (EMS) are largely nonexistent throughout Tanzania and little is known about the communit ... Full text Link to item Cite

Emergency unit capacity in Northern Tanzania: a cross-sectional survey.

Journal Article BMJ Open · February 22, 2023 INTRODUCTION: Emergency medicine (EM) is a growing field in Sub-Saharan Africa. Characterising the current capacity of hospitals to provide emergency care is important in identifying gaps and future directions of growth. This study aimed to characterise th ... Full text Link to item Cite

Shame and Guilt in EMS: A Qualitative Analysis of Culture and Attitudes in Prehospital Emergency Care.

Journal Article Prehosp Emerg Care · 2023 STUDY OBJECTIVES: The shame reaction is a highly negative emotional reaction shown to have long-term deleterious effects on the mental health of clinicians. Prior studies have focused on in-hospital personnel, but very little is known about what drives sha ... Full text Link to item Cite

Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review.

Journal Article Prehosp Emerg Care · 2023 OBJECTIVE: Emergency medical services (EMS) workforce demographics in the United States do not reflect the diversity of the population served. Despite some efforts by professional organizations to create a more representative workforce, little has changed ... Full text Open Access Link to item Cite

Predictors of Non-Transport for Older Adult EMS Patients Encountered for Falls.

Journal Article Prehosp Emerg Care · 2023 BACKGROUND: Emergency medical services (EMS) encounters for falls among older adults have been linked to poor outcomes when the patient is not transported by EMS to a hospital. However, little is known regarding characteristics of this patient population. ... Full text Link to item Cite

Disparities in Emergency Medical Services Care Delivery in the United States: A Scoping Review.

Journal Article Prehosp Emerg Care · 2023 BACKGROUND: Emergency medical services (EMS) often serve as the first medical contact for ill or injured patients, representing a critical access point to the health care delivery continuum. While a growing body of literature suggests inequities in care wi ... Full text Link to item Cite

The association of indoor heat exposure with diabetes and respiratory 9-1-1 calls through emergency medical dispatch and services documentation.

Journal Article Environ Res · September 2022 BACKGROUND: People with pre-existing medical conditions, who spend a large proportion of their time indoors, are at risk of emergent morbidities from elevated indoor heat exposures. In this study, indoor heat of structures wherein exposed people received G ... Full text Link to item Cite

Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest.

Journal Article Resuscitation · September 2022 AIM OF THE STUDY: While out-of-hospital cardiac arrest (OHCA) is associated with poor survival, early bystander CPR (B-CPR) and telephone CPR (T-CPR) improves survival from OHCA. American Heart Association (AHA) Scientific Statements outline recommendation ... Full text Link to item Cite

Medical transport-associated infection: Review and commentary making a case for its legitimacy.

Journal Article Infect Control Hosp Epidemiol · April 2022 The purpose of this article is to summarize existing literature about healthcare-associated infection (HAI) in the medical transport environment and to define the term medical transport-associated infection (MTAI) to unify all previous work under a single ... Full text Link to item Cite

Barriers to accessing follow up care in post-hospitalized trauma patients in Moshi, Tanzania: A mixed methods study.

Journal Article PLOS Glob Public Health · 2022 Disproportionately high injury rates in Sub-Saharan Africa combined with limited access to care in both the acute injury phase and for injury patients requiring continued care after hospital discharge remains a challenge. We aimed to characterize barriers ... Full text Link to item Cite

Emergency Care Sensitive Conditions in Brazil: A Geographic Information System Approach to Timely Hospital Access.

Journal Article Lancet Reg Health Am · December 2021 BACKGROUND: The benefits of treatment for many conditions are time dependent. The burden of these emergency care sensitive conditions (ECSCs) is especially high in low- and middle-income countries. Our objective was to analyze geospatial trends in ECSCs an ... Full text Link to item Cite

Global emergency medicine: A scoping review of the literature from 2020.

Journal Article Acad Emerg Med · November 2021 OBJECTIVE: The objective was to identify, screen, highlight, review, and summarize some of the most rigorously conducted and impactful original research (OR) and review articles (RE) in global emergency medicine (EM) published in 2020 in the peer-reviewed ... Full text Link to item Cite

Traumatic brain injury

Chapter · August 18, 2021 Traumatic brain injury (TBI) is a common cause of death and disability. Primary prevention is focused on injury prevention programs, education, and policies. Prehospital care is focused on rapid identification and prevention of secondary brain injury throu ... Full text Cite

A hypothetical implementation of 'Termination of Resuscitation' protocol for out-of-hospital cardiac arrest.

Journal Article Resusc Plus · June 2021 BACKGROUND: Out-of-hospital cardiac arrests with negligible chance of survival are routinely transported to hospital and many are pronounced dead thereafter. This leads to some potentially avoidable costs. The 'Termination of Resuscitation' protocol allows ... Full text Open Access Link to item Cite

The Role of Emergency Medical Services in the Opioid Epidemic.

Journal Article Prehosp Emerg Care · 2021 The opioid crisis is an ongoing public health concern and EMS agencies are in a critical position to reach at-risk populations. The traditional role of EMS in treating acute opioid overdoses has expanded to include preventative strategies as well as long-t ... Full text Link to item Cite

Helicopter Transportation of Brazilian Trauma Patients: A Comparison of Times to Care.

Journal Article Air Med J · 2021 OBJECTIVE: The purpose of this study was to analyze helicopter emergency medical service (HEMS) transport with secondary land ambulance transfer, comparing landings performed inside and outside the hospital complex to the emergency department. METHODS: Thi ... Full text Link to item Cite

Access to care solutions in healthcare for obstetric care in Africa: A systematic review.

Journal Article PLoS One · 2021 BACKGROUND: Emergency Medical Services (EMS) systems exist to reduce death and disability from life-threatening medical emergencies. Less than 9% of the African population is serviced by an emergency medical services transportation system, and nearly two-t ... Full text Link to item Cite

Predictors of ambulance transport to first health facility among injured patients in southern Sri Lanka.

Journal Article PLoS One · 2021 BACKGROUND: Injuries account for about 13% of all registered deaths in Sri Lanka and are the leading cause of admission to public hospitals. Prehospital trauma care is new to Sri Lanka, and in 2016, a free ambulance service was launched in the Western and ... Full text Link to item Cite

Global Emergency Medicine: A Review of the Literature From 2019.

Journal Article Acad Emerg Med · January 2021 OBJECTIVE: The annual systematic search of the peer-reviewed and gray literature relevant to global emergency medicine (EM) was conducted by the Global Emergency Medicine Literature Review (GEMLR) to screen, evaluate, and review the most rigorously conduct ... Full text Link to item Cite

Evaluating capacity at three government referral hospital emergency units in the kingdom of Eswatini using the WHO Hospital Emergency Unit Assessment Tool.

Journal Article BMC Emerg Med · May 6, 2020 BACKGROUND: The Kingdom of Eswatini, a lower-middle income nation of 1.45 million in southern Africa, has recently identified emergency care as a key strategy to respond to the national disease burden. We aimed to evaluate the current capacity of hospital ... Full text Link to item Cite

Qualitative evaluation of trauma delays in road traffic injury patients in Maringá, Brazil.

Journal Article BMC Health Serv Res · December 2, 2017 BACKGROUND: Road traffic injuries (RTIs) are the eighth leading cause of death worldwide, with an estimated 90% of RTIs occurring in low- and middle-income countries (LMICs) like Brazil. There has been minimal research in evaluation of delays in transport ... Full text Link to item Cite

The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data.

Journal Article BMC Public Health · August 2, 2016 BACKGROUND: Road traffic injuries (RTIs) are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and w ... Full text Link to item Cite

Quality of the Development of Traumatic Brain Injury Clinical Practice Guidelines: A Systematic Review.

Journal Article PLoS One · 2016 Traumatic brain injury (TBI) is a leading cause of death worldwide and is increasing exponentially particularly in low and middle income countries (LMIC). To inform the development of a standard Clinical Practice Guideline (CPG) for the acute management of ... Full text Link to item Cite

Validation of the modified Sgarbossa criteria for acute coronary occlusion in the setting of left bundle branch block: A retrospective case-control study.

Journal Article Am Heart J · December 2015 BACKGROUND: The modified Sgarbossa criteria were proposed in a derivation study to be superior to the original criteria for diagnosing acute coronary occlusion (ACO) in left bundle branch block (LBBB). The new rule replaces the third criterion (5 mm of exc ... Full text Open Access Link to item Cite