In March 2026's journal club we step into a nuanced corner of prehospital care that’s quietly reshaping how systems think about patient destinations. We unpack research from Toronto on paramedics transporting intoxicated patients to a stabilization centre rather than straight to the emergency department. Most patients required no medical interventions in the field, and only a small subset needed later transfer to a hospital. What does this mean for EMS diversion practices, resource use, and paramedic decision-making? Join us for a practical, forward-looking discussion on when less hospital might mean better care in the prehospital world.

Article: Examining a Stabilization Center for Patients with Alcohol or Opioid Intoxication Transported by Paramedics: A Cohort Study of an Emergency Department Diversion Model

Neurologic emergencies don’t wait for the hospital—and neither should neurology education. This episode breaks down a longitudinal EMS curriculum using cases, simulation, and gamification to improve prehospital neurologic assessment. We’ll discuss feasibility, knowledge outcomes, and system-level metrics like door-to-needle time and thrombectomy transfers. Does active learning and simulation meaningfully change prehospital neurologic care—or just test scores? And what does “success” really look like for EMS education?

Article: Curriculum Innovation: Training the Front Line A Neurologic Emergencies Curriculum Pilot for First Responders https://www.neurology.org/doi/10.1212/NE9.0000000000200286

In this month’s journal club episode, we tackle a topic every EMS educator and clinician wrestles with: how do you honor a patient’s end-of-life wishes when they call 911? We unpack a structured review of U.S. EMS protocols and the wide variation in what counts as a valid Do Not Resuscitate (DNR) order, from physician-signed forms to bracelets, POLST-style documents, and even verbal orders. We’ll discuss how these differences can lead to moral distress and affect goal-concordant care, and why understanding the nuances of DNR documentation matters for field providers, system leaders, and anyone who wants to ensure patient wishes are respected in the out-of-hospital setting.