Philipp Hannan

Interests

Research

Disaster Medicine

Teaching

Emergency Medical Services, Disaster Medicine, EKG

Courses

Scholarly Contributions

Chapters

• Nuyen, B., Doo, F., Hannan, P., & Hayon, R. (2019). Prevention. In The EQUAL Curriculum. doi:10.1007/978-3-030-24025-7_5
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  Busy health care providers of sexual and gender minority patients may feel lost when trying to identify long-term priorities for the patient’s care. The motivated clinician seeking guidance on treating special populations may feel discouraged by the limited quality and clarity of currently available evidence. This chapter discusses the challenges of applying mainstream clinical prevention guidelines to sexual and gender minorities. Where major guidelines and interventions can be plausibly adapted, those recommendations are stated. Prevention practices across domains of violence, mental health, substance use, cancer, infectious disease, and bone density are discussed.

Journals/Publications

• Vandergrift, L. A., Rice, A. D., Primeau, K., Gaither, J. B., Munn, R. D., Hannan, P. L., Knotts, M. C., Hollen, A., Stevens, B., Lara, J., & Glenn, M. (2025). Precipitated withdrawal induced by prehospital naloxone administration. Prehospital emergency care, 1-11.
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  Buprenorphine is becoming a key component of prehospital management of opioid use disorder (OUD). It is unclear how many prehospital patients might be eligible for buprenorphine induction, as traditional induction requires that patients first have some degree of opioid withdrawal. The primary aim of this study was to quantify how many patients developed precipitated withdrawal after receiving prehospital naloxone for suspected overdose, as they could be candidates for prehospital buprenorphine. The secondary objective was to identify associated factors contributing to precipitated withdrawal, including dose of naloxone administered, and identify rate of subsequent transport.
• Karra, R., Rice, A. D., Hardcastle, A., V Lara, J., Hollen, A., Glenn, M., Munn, R., Hannan, P., Arcaris, B., Derksen, D., Spaite, D. W., & Gaither, J. B. (2024). Telemedical Direction to Optimize Resource Utilization in a Rural Emergency Medical Services System. The western journal of emergency medicine, 25(5), 777-783.
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  Telemedicine remains an underused tool in rural emergency medical servces (EMS) systems. Rural emergency medical technicians (EMT) and paramedics cite concerns that telemedicine could increase Advanced Life Support (ALS) transports, extend on-scene times, and face challenges related to connectivity as barriers to implementation. Our aim in this project was to implement a telemedicine system in a rural EMS setting and assess the impact of telemedicine on EMS management of patients with chest pain while evaluating some of the perceived barriers.
• Karra, R., Rice, A., Hardcastle, A., Lara, J., Hollen, A., Glenn, M., Munn, R., Hannan, P., Arcaris, B., Derksen, D., Spaite, D., & Gaither, J. (2024). Telemedical Direction to Optimize Resource Utilization in a Rural Emergency Medical Services System. Western Journal of Emergency Medicine, 25(5). doi:10.5811/westjem.18427
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  Background: Telemedicine remains an underused tool in rural emergency medical servces (EMS) systems. Rural emergency medical technicians (EMT) and paramedics cite concerns that telemedicine could increase Advanced Life Support (ALS) transports, extend on-scene times, and face challenges related to connectivity as barriers to implementation. Our aim in this project was to implement a telemedicine system in a rural EMS setting and assess the impact of telemedicine on EMS management of patients with chest pain while evaluating some of the perceived barriers. Methods: This study was a mixed-methods, retrospective review of quality assurance data collected prior to and after implementation of a telemedicine program targeting patients with chest pain. We compared quantitative data from the 12-month pre-implementation phase to data from 15 months post-implementation. Patients were included if they had a chief complaint of chest pain or a 12-lead electrocardiogram had been obtained. The primary outcome was the rate of ALS transport before and after program implementation. Secondary outcomes included EMS call response times and EMS agency performance on quality improvement benchmarks. Qualitative data were also collected after each telemedicine encounter to evaluate paramedic/EMT and EMS physician perception of call quality. Results: The telemedicine pilot project was implemented in September 2020. Overall, there were 58 successful encounters. For this analysis, we included 38 patients in both the pre-implementation period (September 9, 2019–September 10, 2020) and the post-implementation period (September 11, 2020–December 5, 2021). Among this population, the ALS transport rate was 42% before and 45% after implementation (odds ratio 1.11; 95% confidence interval 0.45–2.76). The EMS median out-of-service times were 47 minutes before, and 33 minutes after (P = 0.07). Overall, 64% of paramedics/EMTs and 89% of EMS physicians rated the telemedicine call quality as “good.” Conclusion: In this rural EMS system, a telehealth platform was successfully used to connect paramedics/EMTs to board-certified EMS physicians over a 15-month period. Telemedicine use did not alter rates of ALS transports and did not increase on-scene time. The majority of paramedics/EMTs and EMS physicians rated the quality of the telemedicine connection as “good.”
• Rice, A. D., Hannan, P. L., Kamara, M. I., Gaither, J. B., Blust, R., Chikani, V., Castro-Marin, F., Bradley, G., Bobrow, B. J., Munn, R., Knotts, M., & Lara, J. (2024). Use of Long Spinal Board Post-Application of Protocol for Spinal Motion Restriction for Spinal Cord Injury. The western journal of emergency medicine, 25(5), 793-799.
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  Historically, prehospital care of trauma patients has included nearly universal use of a cervical collar (C-collar) and long spine board (LSB). Due to recent evidence demonstrating harm in using LSBs, implementation of new spinal motion restriction (SMR) protocols in the prehospital setting should reduce LSB use, even among patients with spinal cord injury. Our goal in this study was to evaluate the rates of and reasons for LSB use in high-risk patients-those with hospital-diagnosed spinal cord injury (SCI)-after statewide implementation of SMR protocols.
• Rice, A., Hannan, P., Kamara, M., Gaither, J., Blust, R., Chikani, V., Castro-Marin, F., Bradley, G., Bobrow, B., Munn, R., Knotts, M., & Lara, J. (2024). Use of Long Spinal Board Post-Application of Protocol for Spinal Motion Restriction for Spinal Cord Injury. Western Journal of Emergency Medicine, 25(5). doi:10.5811/westjem.18342
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  Introduction: Historically, prehospital care of trauma patients has included nearly universal use of a cervical collar (C-collar) and long spine board (LSB). Due to recent evidence demonstrating harm in using LSBs, implementation of new spinal motion restriction (SMR) protocols in the prehospital setting should reduce LSB use, even among patients with spinal cord injury. Our goal in this study was to evaluate the rates of and reasons for LSB use in high-risk patients—those with hospital-diagnosed spinal cord injury (SCI)—after statewide implementation of SMR protocols. Methods: Applying data from a state emergency medical services (EMS) registry to a state hospital discharge database, we identified cases in which a participating EMS agency provided care for a patient later diagnosed in the hospital with a SCI. Cases were then retrospectively reviewed to determine the prevalence of both LSB and C-collar use before and after agency adoption of a SMR protocol. We reviewed cases with LSB use after SMR protocol implementation to determine the motivations driving continued LSB use. We used simple descriptive statistics, odds ratios (OR) with 95% confidence intervals (CI) to describe the results. Results: We identified 52 EMS agencies in the state of Arizona with 417,979 encounters. There were 225 patients with SCI, of whom 74 were excluded. The LSBs were used in 52 pre-SMR (81%) and 49 post-SMR (56%) cases. The odds of LSB use after SMR protocol implementation was 70% lower than it had been before implementation (OR 0.297, 95% CI 0.139–0.643; P = 0.002). Use of a C-collar after SMR implementation was not significantly changed (OR 0.51, 95% CI 0.23–1.143; P = 0.10). In the 49 cases of LSB use after agency SMR implementation, the most common reasons for LSB placement were ease of lifting (63%), placement by non-transporting agency (18%), and extrication (16.3%). High suspicion of SCI was determined as the primary or secondary reason for not removing LSB after assessment in 63% of those with LSB placement, followed by multiple transfers required (20%), and critical illness (10%). Conclusion: Implementation of selective spinal motion restriction protocols was associated with a statistically significant decrease in the utilization of long spine boards among prehospital patients with acute traumatic spinal cord injury.
• Glenn, M. J., Rice, A. D., Primeau, K., Hollen, A., Jado, I., Hannan, P., McDonough, S., Arcaris, B., Spaite, D. W., & Gaither, J. B. (2022). Refusals After Prehospital Administration of Naloxone during the COVID-19 Pandemic. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors, 25(1), 46-54.
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  To determine if COVID-19 was associated with a change in patient refusals after Emergency Medical Services (EMS) administration of naloxone.
• Panknin, T., Martin, T. P., Knotts, M., Hannan, P., & Chung, A. (2022). Postcoital cyst rupture presenting as peritonitis and hemorrhagic shock: A case report.. Case reports in women's health, 34, e00402. doi:10.1016/j.crwh.2022.e00402
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  This report presents an unusual case of severe post-coital abdominal pain and signs of hemorrhagic shock requiring admission to a surgical intensive care unit (SICU) and emergent laparoscopy. This case was unique given the timing and progression of the patient's symptoms, as well as her age, surgical history, and symptomatic progression. Here we document the notable characteristics and treatment of this patient..The patient presented to a local emergency department with signs progressive peritonitis and shock after an episode of non-traumatic intercourse. Her initial computed tomography (CT) scan showed signs of free fluid in the abdomen around the bladder and liver with no definitive source of bleed. She developed worsening shock with severe pain. She was then emergently transferred to a tertiary care center for evaluation by gynecology service and for general trauma surgery evaluation. She was further stabilized in the emergency department, and then admitted to the surgical critical care service. Following additional imaging, she received exploratory surgery with gynecology to control a hemorrhagic ruptured cyst. She remained stable and was discharged the next day..This case demonstrated a complication of an often-benign diagnosis, revealing the potential danger of underestimating this chief complaint, as well as the importance of understanding how minimal trauma can lead to cyst rupture.

Proceedings Publications

• Acuna, J. G., Rice, A., Munn, R., Hannan, P., & Gaither, J. B. (2024, January). Acuna JG, Snell EW, Rice AD, Hannan PL, Munn R, Wise JN, Bradley G, Zenuk-Garcia R, Gaither JB.Ultrasound-Guidance for Peripheral Intravenous Access Among Paramedics in the Emergency Department. . In Prehosp Emerg Care.
• Gaither, J. B., Hannan, P., Munn, R., Spaite, D. W., & Rice, A. (2024, January). A liberal shocking strategy distorts Utstein survival calculation for out of hospital cardiac arrests: Knotts MC, Gaither JB, Hannan PL, Hollen A, Munn R, Spaite DW, Johnson H, Keeley B, Twilling S, Rice AD.   . In Prehospital Emergency Care.
• Hannan, P., DeMers, D., Shihab, S., Camarillo, R., Bethel, A., Ng, V., Knotts, M., Liu, J., Munn, R., Rice, A., & Gaither, J. B. (2024, January). MCI Triage Accuracy Among Resident Physicians. In Prehospital Emergency Care.
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  2023: Approximately 1.75 hours spent on project
• Hannan, P., Gaither, J. B., DeMers, D., Rice, A., Shihab, S., Munn, R., Liu, J., Camarillo, R., Bethel, A., Knotts, M., Ng, V., Ng, V., Knotts, M., Bethel, A., Liu, J., Camarillo, R., Shihab, S., Munn, R., DeMers, D., , Rice, A., et al. (2024, January).

  MCI Triage Accuracy Among Resident Physicians

  . In Prehospital Emergency Care, 28, S1-S111.
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  2023: Approximately 50 hours spent on project
• Wise, J. N., Rice, A., Lara, J. N., Munn, R., Knotts, M. R., Hannan, P., Spaite, D. W., & Gaither, J. B. (2024, January).

  Young Adult Willingness to use Automated Defibrillators and Perspectives on Early Bystander Defibrillation

  . In Prehospital Emergency Care.
• Gaither, J. B., Gaither, J. B., Rice, A., Rice, A., Hannan, P., Hannan, P., Munn, R., Munn, R., Dolana, B., Dolana, B., Doty, B., Doty, B., Hollen, A., Hollen, A., Knotts, M., Knotts, M., Stevens, B., Stevens, B., McDonough, S., , McDonough, S., et al. (2023, Jan). Automation of Out-Of-Hospital Cardiac Arrest Case Review improves EMS provider Performance on Benchmarks. In Prehospital Emergency Care, 27, S1-S96.
• Rice, A., Adrienne, H., Munn, R., Hannan, P., Mary, K., Beskind, D. L., French, R. N., Spaite, D. W., & Gaither, J. B. (2023, Jan).

  Improved time to turn around quality improvement feedback to providers using novel integrated quality improvement and feedback system

  . In Prehospital Emergency Care, 27, S74-75.

Presentations

• Gaither, J. B., Rice, A., Hannan, P., Munn, R., Dolana, B., Doty, B., Hollen, A., Knotts, M., Stevens, B., McDonough, S., French, R. N., Beskind, D. L., & Spaite, D. W. (2023, Jan). Automation of Out-Of-Hospital Cardiac Arrest Case Review improves EMS provider Performance on Benchmarks. Scientific Assembly of the National Association of EMS Physicians. Tampa, Florida: National Association of EMS Physicians.
• Hannan, P. (2023, April). Workshop #3: EMS Experiences from the Field. AzCHER Crisis Standards of Care Workshop Series. Phoenix: AzCHER.
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  Presented to a state symposium on disaster management and crisis standards of care. 
• Rice, A., Adrienne, H., Munn, R., Hannan, P., Mary, K., Beskind, D. L., French, R. N., Spaite, D. W., & Gaither, J. B. (2023, Jan).

  Improved time to turn around quality improvement feedback to providers using novel integrated quality improvement and feedback system

  . Scientific Assembly of the National Association of EMS Physicians. Tampa, Florida: National Association of EMS Physicians.

Poster Presentations

• Acuna, J. G., Rice, A., Munn, R., Hannan, P., & Gaither, J. B. (2024, January). Acuna JG, Snell EW, Rice AD, Hannan PL, Munn R, Wise JN, Bradley G, Zenuk-Garcia R, Gaither JB.Ultrasound-Guidance for Peripheral Intravenous Access Among Paramedics in the Emergency Department. . National Association of EMS Physicians Annual Meeting.
• Gaither, J. B., Hannan, P., Munn, R., Spaite, D. W., & Rice, A. (2024, January 8 - 13). A liberal shocking strategy distorts Utstein survival calculation for out of hospital cardiac arrests: Knotts MC, Gaither JB, Hannan PL, Hollen A, Munn R, Spaite DW, Johnson H, Keeley B, Twilling S, Rice AD.   . Presented at the Annual Scientific Assembly of the National Association of EMS Physicians.. Austin, Texas.
• Gaither, J. B., Hannan, P., Munn, R., Spaite, D. W., & Rice, A. (2024, January). A liberal shocking strategy distorts Utstein survival calculation for out of hospital cardiac arrests: Knotts MC, Gaither JB, Hannan PL, Hollen A, Munn R, Spaite DW, Johnson H, Keeley B, Twilling S, Rice AD.   . National Association of EMS Physicians Annual Scientific Assembly. Austin, Texas.
• Glenn, M., Rice, A., Munn, R., Hannan, P., Primeau, K., & Gaither, J. B. (2024, January 8-13). Examination of the Relationship between Opiate Overdoses, EMS Refusals, and COVID-19 Case-Spikes: Schwyhart RE, Glenn M, Vandergrift L, Rice AD, Liu J, Munn R, Hannan PL, Hollen A, Primeau K, Gaither JB. . Presented at the Annual Scientific Assembly of the National Association of EMS Physicians. Austin, Texas.
• Hannan, P., DeMers, D., Shihab, S., Camarillo, R., Bethel, A., Ng, V., Knotts, M., Liu, J., Munn, R., Rice, A., & Gaither, J. B. (2024, January). MCI Triage Accuracy Among Resident Physicians. The Annual Scientific Assembly of the National Association of EMS Physicians. Austin, Texas: National Association of EMS Physicians.
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  2023: Approximately 1.75 hours spent on project
• Knotts, M., Gaither, J. B., Hannan, P., Munn, R., Hollen, A., Haley, J., Brian, K., Shawn, T., & Rice, A. (2024, January). A Liberal Shocking Strategy Distorts Utstein Survival Calculation for Out of Hospital Cardiac Arrests. NAEMSP Annual Conference. Austin, TX.
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  The Menegazzi Scientific Sessions: Research Abstracts for the 2024 National Association of EMS Physicians Annual Meeting. (2023). Prehospital Emergency Care, 28(sup1), S1–S111. https://doi.org/10.1080/10903127.2023.2273890
• Knotts, M., Rice, A., Wise, J. N., Dolana, B., Joshua, C., Doty, B., Hannan, P., Munn, R., Lerman, M., & Gaither, J. B. (2024, January). Comparison of Direct Laryngoscopy and Video Laryngoscopy on Difficult Airway Mannequins in the Prehospital Setting. NAEMSP Annual Conference. Austin, TX.
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  The Menegazzi Scientific Sessions: Research Abstracts for the 2024 National Association of EMS Physicians Annual Meeting. (2023). Prehospital Emergency Care, 28(sup1), S1–S111. https://doi.org/10.1080/10903127.2023.2273890
• Rice, A., Munn, R., Hannan, P., & Gaither, J. B. (2024, January 8 - 13). Comparison of Direct Laryngoscopy and Video Laryngoscopy on Difficult Airway Mannequins in the Prehospital Setting: Knotts MC, Rice AD, Wise JN, Dolana BM, Calton JB, Doty BK, Hannan PL, Munn R, Lerman MM, Gaither JB.  . Presented at the Annual Scientific Assembly of the National Association of EMS Physicians.. Austin, Texas.
• Rice, A., Munn, R., Hannan, P., Spaite, D. W., & Gaither, J. B. (2024, January 8 - 13).

  Young Adult Willingness to use Automated Defibrillators and Perspectives on Early Bystander Defibrillation: Wise JN, Rice AD, Lara JV, Munn, Knotts MR, Hannan PL, Spaite DW, Gaither JB.

  . Presented at the Annual Scientific Assembly of the National Association of EMS Physicians.. Austin, Texas.
• Rice, A., Hannan, P., Gaither, J. B., Munn, R., Rice, A., Hannan, P., Gaither, J. B., & Munn, R. (2022, January). Comparison of Various Video Laryngoscope Devices in Indoor and Outdoor Simulated Endotracheal Intubation. NAEMSP Annual Meeting. San Diego, California.

Others

• Gaither, J. B., Tony, R., Shawn, T., Brian, K., Brian, S., Mary, K., French, R. N., Beskind, D. L., Munn, R., Hannan, P., & Rice, A. (2022, January).

  University Emergency Medical Services Guidelines - Prehospital guidelines for the care of patients with emergency medical conditions

  . https://emergencymed.arizona.edu/ems-private/public/admin-guidelines