Establishing consensus‐based high‐acuity low‐occurrence skills for EMS physicians: A pilot survey of EMS fellowship faculty

The specialty of emergency medical services (EMS) medicine focuses on providing out‐of‐hospital patient care, including initial stabilization, treatment, and transport in specially equipped vehicles including ambulances and airframe platforms to hospitals and better‐resourced destinations. The Core Content of EMS Medicine outlines the knowledge, procedures, and psychomotor skills relevant to prehospital patient care. However, this document does not specify the high‐consequence skills that are infrequently performed and that carry high levels of complexity as well as potential morbidity. We refer to these as high‐acuity low‐occurrence (HALO) skills. Additionally, there is no consensus definition of what meets the criteria for a HALO skill. The goals of this pilot study were twofold: (1) to determine a consensus definition for a HALO skill and (2) to survey EMS fellowship faculty to identify an initial set of EMS physician trainee skills that meet the HALO definition.