Benjamin Lindquist

All Publications

• Teaching From Afar: Development of a Telemedicine Curriculum for Healthcare Workers in Global Settings CUREUS Lowe, J. T., Patel, S. R., Hao, W. D., Butt, A., Strehlow, M., Lindquist, B. 2021; 13 (12)

  View details for DOI 10.7759/cureus.20123

  View details for Web of Science ID 000728576500001

• Development and implementation of a novel Web-based gaming application to enhance emergency medical technician knowledge in low- and middle-income countries. AEM education and training Lindquist, B., Gaiha, S. M., Vasudevan, A., Dooher, S., Leggio, W., Mulkerin, W., Zozula, A., Strehlow, M., Sebok-Syer, S. S., Mahadevan, S. V. 2021; 5 (3): e10602

  Abstract

  Background: Increasing access to high-quality emergency and prehospital care is an important priority in low- and middle-income countries (LMICs). However, ensuring that emergency medical technicians (EMTs) maintain their clinical knowledge and proficiency with procedural skills is challenging, as continuing education requirements are still being introduced, and clinical instructional efforts need strengthening. We describe the development and implementation of an innovative asynchronous learning tool for EMTs in the form of a Web-based trivia game.Methods: Over 500 case-based multiple-choice questions (covering 10 essential prehospital content areas) were created by experts in prehospital education, piloted with EMT educators from LMICs, and delivered to EMTs through a Web-based quiz game platform over a 12-week period. We enrolled 252 participants from nine countries.Results: Thirty-two participants (12.7%) completed the entire 12-week game. Participants who completed the game were administered a survey with a 100% response rate. Ninety-three percent of participants used their mobile phone to access the game. Overall, participants reported that the interface was easy to use (93.8% agreed or strongly agreed), the game improved their knowledge (100% agreed or strongly agreed), and they felt better prepared for their jobs (100% agreed or strongly agreed). The primary motivators for participation were improving patient care (37.5%) and being recognized on the game's leaderboard (31.3%). All participants reported that they would engage in the game again (43.8% agreed and 56.3% strongly agreed) and would recommend the game to their colleagues (34.4% agreed and 65.6% strongly agreed).Conclusions: In conclusion, a quiz game targeting EMT learners from LMICs was viewed as accessible and effective by participants. Future efforts should focus on increasing retention and trialing languages in addition to English.

  View details for DOI 10.1002/aet2.10602

  View details for PubMedID 34124530

• Experiences of Workplace Violence Among Healthcare Providers in Myanmar: A Cross-sectional Survey Study CUREUS Lindquist, B., Feltes, M., Niknam, K., Koval, K. W., Ohn, H., Newberry, J., Strehlow, M., Walker, R. 2020; 12 (4)

  View details for DOI 10.7759/cureus.7549

  View details for Web of Science ID 000523464200005

• A Body Bag Can Save Your Life: A Novel Method of Cold Water Immersion for Heat Stroke Treatment A Body Bag Can Save Your Life: A Novel Method of Cold Water Immersion for Heat Stroke Treatment Kim, D. A., Lindquist, B. D., Shen, S. H., Wagner, A. M., Lipman, G. S. 2020: 4

  View details for DOI 10.1002/emp2.12007

• First look at emergency medical technician wellness in India: Application of the Maslach Burnout Inventory in an unstudied population. PloS one Koval, K. W., Lindquist, B. n., Gennosa, C. n., Mahadevan, A. n., Niknam, K. n., Patil, S. n., Rao, G. V., Strehlow, M. C., Newberry, J. A. 2020; 15 (3): e0229954

  Abstract

  Professional wellness is critical to developing and maintaining a health care workforce. Previous work has identified burnout as a significant challenge to professional wellness facing emergency medical technicians (EMTs) in many countries worldwide. Our study fills a critical gap by assessing the prevalence of burnout among emergency medical technicians (EMTs) in India.This was a cross-sectional survey of EMTs within the largest prehospital care organization in India. We used the Maslach Burnout Inventory (MBI) to measure wellness. All EMTs presenting for continuing medical education between July-November 2017 from the states of Gujarat, Karnataka, and Telangana were eligible. Trained, independent staff administered anonymous MBI-Medical Personnel Surveys in local languages.Of the 327 EMTs eligible, 314 (96%) consented to participate, and 296 (94%) surveys were scorable. The prevalence of burnout was 28.7%. Compared to EMTs in other countries, Indian EMTs had higher levels of personal accomplishment but also higher levels of emotional exhaustion and moderate levels of depersonalization. In multivariate regression, determinants of burnout included younger age, perceived lack of respect from colleagues and administrators, and a sense of physical risk. EMTs who experienced burnout were four times as likely to plan to quit their jobs within one year.This is the first assessment of burnout in EMTs in India and adds to the limited body of literature among low- and middle-income country (LMIC) prehospital providers worldwide. Burnout was strongly associated with an EMT's intention to quit within a year, with potential implications for employee turnover and healthcare workforce shortages. Burnout should be a key focus of further study and possible intervention to achieve internationally recognized targets, including Sustainable Development Goal 3C and WHO's 2030 Milestone for Human Resources.

  View details for DOI 10.1371/journal.pone.0229954

  View details for PubMedID 32155192

• Continuing Education for Prehospital Healthcare Providers in India - A Novel Course and Concept. Open access emergency medicine : OAEM Lindquist, B. D., Koval, K. W., Acker, P. C., Bills, C. B., Khan, A. n., Zachariah, S. n., Newberry, J. A., Rao, G. V., Mahadevan, S. V., Strehlow, M. C. 2020; 12: 201–10

  Abstract

  Emergency medical services (EMS) in India face enormous challenges in providing care to a geographically expansive and diverse patient population. Over the last decade, the public-private-partnership GVK EMRI (Emergency Management and Research Institute) has trained over 100,000 emergency medical technicians (EMTs), with greater than 21,000 currently practicing, to address this critical gap in the healthcare workforce. With the rapid development and expansion of EMS, certain aspects of specialty development have lagged behind, including continuing education requirements. To date, there have been no substantial continuing education EMT skills and training efforts. We report lessons learned during development and implementation of a continuing education course (CEC) for EMTs in India.From 2014 to 2017, we employed an iterative process to design and launch a novel CEC focused on five core emergency competency areas (medicine and cardiology, obstetrics, trauma, pediatrics, and leadership and communication). Indian EMT instructors and providers partnered in design and content, and instructors were trained to independently deliver the CEC. Many challenges had to be overcome: scale (>21,000 EMTs), standardization (highly variable skill levels among providers and instructors), culture (educational emphasis on rote memorization rather than practical application), and translation (22 major languages and a few hundred local dialects spoken nationwide).During the assessment and development phases, we identified five key strategies for success: (1) use icon-based video instruction to ensure consistent quality and allow voice-over for easy translation; (2) incorporate workbooks during didactic videos and (3) employ low-cost simulation and case discussions to emphasize active learning; (4) focus on non-technical skills; (5) integrate a formal training-of-trainers prior to delivery of materials.These key strategies can be combined with innovation and flexibility to address unique challenges of language, system resources, and cultural differences when developing impactful continuing educational initiatives in bourgeoning prehospital care systems in low- and middle-income countries.

  View details for DOI 10.2147/OAEM.S249447

  View details for PubMedID 32982494

  View details for PubMedCentralID PMC7505709

• Workplace violence among prehospital care providers in India: a cross-sectional study. BMJ open Lindquist, B., Koval, K., Mahadevan, A., Gennosa, C., Leggio, W., Niknam, K., Rao, G. V., Newberry, J. A., Strehlow, M. 2019; 9 (11): e033404

  Abstract

  OBJECTIVES: The purpose of this study was twofold: (1) establish the prevalence of safety threats and workplace violence (WPV) experienced by emergency medical technicians (EMTs) in a low/middle-income country with a new prehospital care system, India and (2) understand which EMTs are at particularly high risk for these experiences.SETTING: EMTs from four Indian states (Gujarat, Karnataka, Tamil Nadu and Telangana) were eligible to participate during the study period from July through November 2017.METHODS: Cross-sectional survey study.PARTICIPANTS: 386 practicing EMTs from four Indian states.RESULTS: The overall prevalence of any WPV was 67.9% (95%CI 63.0% to 72.5%). The prevalence of physical assault was 58% (95% CI 52.5% to 63.4%) and verbal assault was 59.8% (95% CI 54.5% to 65%). Of physical assault victims, 21.7% were injured and 30.2% sought medical attention after the incident. Further, 57.3% (n=216) of respondents reported they were 'somewhat worried' and 28.4% (n=107) reported they were 'very worried' about their safety at work.CONCLUSION: WPV and safety fears were found to be common among EMTs in India. Focused initiatives to counter WPV in countries developing prehospital care systems are necessary to build a healthy and sustainable prehospital healthcare workforce.

  View details for DOI 10.1136/bmjopen-2019-033404

  View details for PubMedID 31772106

• A Posterior Circulation Stroke Presenting with Isolated Truncal Ataxia. Cureus Migliaccio, D. n., Lindquist, B. n. 2017; 9 (9): e1709

  Abstract

  Vertebral artery dissection is an infrequent and often misdiagnosed cause of stroke. In this case report, we describe a patient with a posterior circulation stroke caused by a vertebral artery dissection, who presented to the emergency department with isolated truncal ataxia. This case emphasizes the importance of obtaining a thorough history and physical exam for all neurologic complaints, including a careful ambulation assessment.

  View details for PubMedID 29188153

  View details for PubMedCentralID PMC5703583

• Adult Epiglottitis: A Case Series. The Permanente journal Lindquist, B., Zachariah, S., Kulkarni, A. 2017; 21

  Abstract

  Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis.We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis. Three of the patients improved with conservative measures and were observed in the intensive care unit. One patient required an emergent tracheostomy.This series of patients is unique in that all four patients presented to a single Emergency Department within a few days of each other and, despite a myriad of presenting chief complaints, the patients were eventually found to have the same potentially life-threatening diagnosis.These cases reinforce the variability of presenting symptoms and physical examination findings that can occur in patients with epiglottitis. They also highlight clinical findings and adjunctive testing that can help identify patients who would most benefit from intervention.

  View details for DOI 10.7812/TPP/16-089

  View details for PubMedID 28241903

  View details for PubMedCentralID PMC5283781

• Hemorrhagic Contents Within Uterine Sac Mimicking Intrauterine Pregnancy on Point-of-Care Ultrasound: A Case Report of a Ruptured Ectopic Pregnancy Emerg Med Open J Lindquist, B., Perera, P., Chao, A., Lobo, V., Gharahbaghian 2016; 2 (1): 11-14

  View details for DOI 10.17140/EMOJ-2-121

• Barriers to Real-Time Medical Direction via Cellular Communication for Prehospital Emergency Care Providers in Gujarat, India. Cure¯us Lindquist, B., Strehlow, M. C., Rao, G. V., Newberry, J. A. 2016; 8 (7)

  Abstract

  Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care. We sought to identify obstacles in the cellular communication process among GVK Emergency Management and Research Institute (GVK EMRI) EMTs in Gujarat, India.A convenience sample of practicing EMTs in Gujarat, India were surveyed regarding the barriers to call initiation and completion.108 EMTs completed the survey. Overall, ninety-seven (89.8%) EMTs responded that the most common reason they did not initiate a call with the call center physician was insufficient time. Forty-six (42%) EMTs reported that they were unable to call the physician one or more times during a typical workweek (approximately 5-6 twelve-hour shifts/week) due to their hands being occupied performing direct patient care. Fifty-eight (54%) EMTs reported that they were unable to reach the call center physician, despite attempts, at least once a week.This study identified multiple barriers to communication, including insufficient time to call for advice and inability to reach call center physicians. Identification of simple interventions and best practices may improve communication and ensure timely and appropriate prehospital care.

  View details for DOI 10.7759/cureus.676

  View details for PubMedID 27551654

  View details for PubMedCentralID PMC4977222

• Maisonneuve Fracture - A can’t miss diagnosis! Lindquist, B. American Academy of Emergency Medicine:Resident and Student Association. 2015
• Diagnosis and Treatment of Skin and Soft Tissue Infections in the Pediatric Emergency Department Pediatric Emergency Medicine Reports Lindquist, B., Wang, N. 2015; 20 (7)
• Scrotal Swelling in the Neonate Lindquist, B., Chang, J., McClure, C. American Academy of Emergency Medicine:Resident and Student Association. 2015
• Interstitial Neuritis Masquerading as Acute Appendicitis: A Case Report Emergency Medicine-Open Access Lindquist, B., Gharahbaghian, L. 2014; 4 (4)

  View details for DOI 10.4172/2165-7548.1000194

• VACTERL Association Lindquist, B. PEMSoft v12. 2013
• Charge Association Lindquist, B. PEMSoft v12. 2013
• Prader-Willi Syndrome Lindquist, B. PEMSoft v12. 2013