Scholars@Duke
Mehul Dinesh Patel

Mehul Dinesh Patel

Instructor in the Department of Emergency Medicine
Emergency Medicine

Selected Publications

Evaluation of the Implementation of a Novel Fluid Resuscitation Device in the Prehospital Care of Sepsis Patients: Application of the Implementation Outcomes Framework.

Journal Article Prehosp Emerg Care · 2025 OBJECTIVES: Early identification and fluid resuscitation are recognized performance measures within sepsis care. Despite fluid resuscitation, fluid goals are often not achieved in the prehospital environment. Furthermore, description of implementation proc ... Full text Link to item Cite

Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina.

Journal Article J Rural Health · January 2025 PURPOSE: Acute stroke is a serious, time-sensitive condition requiring immediate medical attention. Emergency medical services (EMS) routing and direct transport of acute stroke patients to stroke centers improves timely access to care. This study aimed to ... Full text Link to item Cite

Rural Emergency Medical Services Perspectives on Improving Acute Stroke Care: A Qualitative Study.

Journal Article Prehosp Emerg Care · 2025 OBJECTIVES: For underserved rural communities with limited geographical access to comprehensive stroke centers, emergency medical services (EMS) play a crucial role in timely, high-quality acute stroke care. This qualitative study aimed to understand rural ... Full text Link to item Cite

In-Hospital Code Status Updates: Trends Over Time and the Impact of COVID-19.

Journal Article Am J Hosp Palliat Care · November 2024 OBJECTIVE: The primary objective was to evaluate if the percentage of patients with missing or inaccurate code status documentation at a Trauma Level 1 hospital could be reduced through daily updates. The secondary objective was to examine if patient prefe ... Full text Link to item Cite

Effectiveness of a Novel Rapid Infusion Device and Clinician Education for Early Fluid Therapy by Emergency Medical Services in Sepsis Patients: A Pre-Post Observational Study.

Journal Article Prehosp Emerg Care · 2024 OBJECTIVE: Emergency medical services (EMS) clinicians are tasked with early fluid resuscitation for patients with sepsis. Traditional methods for prehospital fluid delivery are limited in speed and ease-of-use. We conducted a comparative effectiveness stu ... Full text Link to item Cite

Statewide availability of acute stroke treatment, services, and programs: A survey of North Carolina Hospitals.

Journal Article J Stroke Cerebrovasc Dis · October 2023 INTRODUCTION: We conducted a statewide assessment of the availability of stroke treatment, services, and programs in North Carolina (NC) hospitals. We also examined differences in stroke care capabilities between urban, suburban, and rural hospitals and tr ... Full text Link to item Cite

Community Socioeconomic and Urban-Rural Disparities in Prehospital Notification of Stroke by Emergency Medical Services in North Carolina.

Journal Article South Med J · September 2023 OBJECTIVES: Notification by emergency medical services (EMS) to the destination hospital of an incoming suspected stroke patient is associated with timelier in-hospital evaluation and treatment. Current data on adherence to this evidence-based best practic ... Full text Link to item Cite

Organizational decision-making during COVID-19: A qualitative analysis of the organizational decision-making system in the United States during COVID-19

Journal Article Journal of Contingencies and Crisis Management · June 1, 2023 This study sought to understand COVID-19-related organizational decisions were made across sectors. To gain this understanding, we conducted semi-structured interviews with organizational decision-makers in North Carolina about their experiences responding ... Full text Cite

EMS Involvement in COVID-19 Vaccination Efforts - Results of a North Carolina Statewide Survey.

Journal Article Prehosp Emerg Care · 2023 Objective: The COVID-19 pandemic has necessitated the vaccination of large numbers of people across the United States, mobilizing public health resources on a massive scale. The purpose of this study is to determine how emergency medical services (EMS) cli ... Full text Link to item Cite

Prehospital Fluid Administration for Suspected Sepsis in a Large EMS System: Opportunities to Improve Goal Fluid Delivery.

Journal Article Prehosp Emerg Care · 2023 OBJECTIVES: Despite EMS-implemented screening and treatment protocols for suspected sepsis patients, prehospital fluid therapy is variable. We sought to describe prehospital fluid administration in suspected sepsis patients, including demographic and clini ... Full text Link to item Cite

Disparities in emergency department prioritization and rooming of patients with similar triage acuity score.

Journal Article Acad Emerg Med · November 2022 BACKGROUND: We identify patient demographic and emergency department (ED) characteristics associated with rooming prioritization decisions among ED patients who are assigned the same triage acuity score. METHODS: We performed a retrospective analysis of ad ... Full text Link to item Cite

Performance of the vision, aphasia, neglect (VAN) assessment within a single large EMS system.

Journal Article J Neurointerv Surg · April 2022 BACKGROUND: There is limited evidence on the performance of emergent large-vessel occlusion (LVO) stroke screening tools when used by emergency medical services (EMS) and emergency department (ED) providers. We assessed the validity and predictive value of ... Full text Link to item Cite

Identifying Patient Phenotype Cohorts Using Prehospital Electronic Health Record Data.

Journal Article Prehosp Emerg Care · 2022 Objective: Emergency medical services (EMS) provide critical interventions for patients with acute illness and injury and are important in implementing prehospital emergency care research. Retrospective, manual patient record review, the current reference- ... Full text Link to item Cite

Use of Modeling to Inform Decision Making in North Carolina during the COVID-19 Pandemic: A Qualitative Study.

Journal Article MDM Policy Pract · 2022 UNLABELLED: Background. The COVID-19 pandemic has popularized computer-based decision-support models, which are commonly used to inform decision making amidst complexity. Understanding what organizational decision makers prefer from these models is needed ... Full text Link to item Cite

Disparities in Emergency Medical Services Time Intervals for Patients with Suspected Acute Coronary Syndrome: Findings from the North Carolina Prehospital Medical Information System.

Journal Article J Am Heart Assoc · August 3, 2021 Background Timely emergency medical services (EMS) response, management, and transport of patients with suspected acute coronary syndrome (ACS) significantly reduce delays to emergency treatment and improve outcomes. We evaluated EMS response, scene, and t ... Full text Link to item Cite

Novel Use of Telemedicine by Hurricane Evacuation Shelters.

Journal Article Prehosp Emerg Care · 2020 Introduction: Hurricane Florence made landfall in North Carolina as a Category 1 hurricane on September 14, 2018 causing catastrophic flooding throughout much of eastern North Carolina. Large numbers of evacuees were housed in evacuation shelters establish ... Full text Link to item Cite

Emergency Medical Services Time Intervals for Acute Chest Pain in the United States, 2015-2016.

Journal Article Prehosp Emerg Care · 2020 Background: Chest pain is a leading complaint in emergency settings. Timely emergency medical services (EMS) responses can reduce delays to treatment and improve clinical outcomes for acute myocardial infarction patients and other medical emergencies. We i ... Full text Link to item Cite

A Statewide Assessment of Prehospital Electrocardiography Approaches of Acquisition and Interpretation for ST-Elevation Myocardial Infarction Based on Emergency Medical Services Characteristics.

Journal Article Prehosp Emerg Care · 2020 Background: The American Heart Association recommends acquiring and interpreting prehospital electrocardiograms (ECG) for patients transported by Emergency Medical Services (EMS) to the emergency department with symptoms highly suspicious of acute coronary ... Full text Link to item Cite

Identifying Opioid Use Disorder in the Emergency Department: Multi-System Electronic Health Record-Based Computable Phenotype Derivation and Validation Study.

Journal Article JMIR Med Inform · October 31, 2019 BACKGROUND: Deploying accurate computable phenotypes in pragmatic trials requires a trade-off between precise and clinically sensical variable selection. In particular, evaluating the medical encounter to assess a pattern leading to clinically significant ... Full text Link to item Cite

Availability of Hospital Resources and Specialty Services for Stroke Care in North Carolina.

Journal Article South Med J · June 2019 OBJECTIVES: Effective regionalization of acute stroke care requires assessment and coordination of limited hospital resources. We described the availability of stroke-specific hospital resources (neurology specialty physicians and neuro-intensive care unit ... Full text Link to item Cite

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool.

Journal Article J Elder Abuse Negl · 2018 Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple ... Full text Link to item Cite