To see the other types of publications on this topic, follow the link: Paramedic.
Journal articles on the topic 'Paramedic'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Paramedic.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Schaider, Jeffrey J., John C. Riccio, Robert J. Rydman, and Peter T. Pons. "Paramedic Diagnostic Accuracy for Patients Complaining of Chest Pain or Shortness of Breath." Prehospital and Disaster Medicine 10, no. 4 (December 1995): 245–50. http://dx.doi.org/10.1017/s1049023x00042114.
Full textAbstract:
AbstractIntroduction:A multitude of life-threatening and nonlife-threatening processes cause chest pain and shortness of breath. Prehospital therapy for these patients may be lifesaving and includes pharmacologic interventions, as well as invasive procedures. Appropriate therapy depends on the diagnostic skills of the paramedic.Objective:This study was undertaken to determine the accuracy of the paramedic diagnosis in patients transported with a chief complaint of pain or shortness of breath.Setting:Multihospital, one large municipal hospital, one community hospital.Design:Prospective, cross-sectional study. Paramedics evaluated the patient and then completed a standard form indicating the diagnosis. The paramedic's and final emergency physician's diagnoses were compared to assess the accuracy of the paramedic diagnosis.Population:All patients who complained of chest pain or shortness of breath, transported to the study centers by the city of Denver paramedia, were eligible for the study. Ninety-nine of the 102 patients enrolled had complete records for analysis and were entered into the study.Results:Diagnostic concordance data were analyzed by organ system (e.g., cardiac, pulmonary, etc.) and for specific diagnoses using the kappa statistic and McNemar's chi-square analysis for discordant pairs. Using the kappa statistic, there was statistically significant concordance between the paramedic and emergency-physician diagnosis for cardiac (p = 0.0001; kappa value = 0.54) and pulmonary organ systems (p = 0.0001; kappa value = 0.61). Overall, for organ system diagnosis, the paramedics had an 82% accuracy (p = 0.05) rating. For specific cardiac and pulmonary diagnosis, paramedics had good concordance with emergency physicians.Conclusions:Overall, paramedia have excellent diagnosis by organ system. They retained good agreement on specific cardiac diagnoses and pulmonary diagnosis.
2
Charlton, Karl, John Franklin, and Rebekah McNaughton. "Phenomenological study exploring ethics in prehospital research from the paramedic’s perspective: experiences from the Paramedic-2 trial in a UK ambulance service." Emergency Medicine Journal 36, no. 9 (August 19, 2019): 535–40. http://dx.doi.org/10.1136/emermed-2019-208556.
Full textAbstract:
ObjectivesWe set out to investigate paramedics’ views of ethics and research, drawing on experiences from Paramedic-2, a randomised controlled trial comparing epinephrine and placebo in out-of-hospital cardiac arrest (OHCA).MethodsAn interpretative phenomenological approach was adopted. A purposive sample of paramedics (n=6) from North East Ambulance Service NHS Foundation Trust were invited to a semi-structured, in-depth interview.ResultsThree superordinate themes emerged: (1) morality, (2) emotion and (3) equipoise. Some viewed Paramedic-2 as an opportunity to improve OHCA outcomes for the many, viewing participation as a moral obligation; others viewed the study as unethical, equating participation with immoral behaviour. Morality was a motivator to drive individual action. Positive and negative emotions were exhibited by the paramedics involved reflecting the wider view each paramedic held about trial participation. Those morally driven to participate in Paramedic-2 discussed their pride in being associated with the trial, while those who found participation unethical, discussed feelings of guilt and regret. Individual experience and perceptions of epinephrine guided each paramedic’s willingness to accept or reject equipoise. Some questioned the role of epinephrine in OHCA; others believed withholding epinephrine was synonymous to denying patient care.ConclusionA paucity of evidence exists to support any beneficial role of epinephrine in OHCA. Despite this, some paramedics were reluctant to participate in Paramedic-2 and relied on their personal perceptions and experiences of epinephrine to guide their decision regarding participation. Failure to acknowledge the importance of individual perspectives may jeopardise the success of future out-of-hospital trials.
3
Matis, Vladimir I., Sharbanu O. Uysenbaeva, and Lyudmila M. Pivina. "DEVELOPMENT OF THE “PARAMEDICINE” EDUCATIONAL PROGRAM." Vestnik Altaiskogo Gosudarstvennogo Pedagogiceskogo Universiteta, no. 53 (December 5, 2022): 35–41. http://dx.doi.org/10.37386/2413-4481-2022-4-35-41.
Full textAbstract:
The issue of introducing paramedic services is currently relevant for the healthcare systems of Russia and Kazakhstan. The article describes the experience of developing a training program for paramedics based on the analysis and synthesis of scientific publications in evidence-based medicine databases (PubMed, UpToDate, TripDatabase, ResearchGate, GoogleScholar, CyberLeninka). The criteria for inclusion of publications in the analysis were the presence of keywords (paramedical service, emergency medicine, emergency medical services, emergency health care system, paramedic) and the publication period from 2000 to 2019.
4
Holmes, Lisa. "Exploring the Preparedness of Student Paramedics for the Mental Health Challenges of the Paramedic Profession." Prehospital and Disaster Medicine 34, s1 (May 2019): s83. http://dx.doi.org/10.1017/s1049023x19001742.
Full textAbstract:
Introduction:The mental health challenges encountered by paramedics have received much attention in recent years. This attention has particularly focused on high rates of stress, depression, anxiety, and post-traumatic stress disorder. This heightened awareness of the high incidence of mental illness, which has at times tragically resulted in the suicide of serving and former paramedics, is stimulating the address of mental health within the paramedic profession. It is now time to call on paramedic educators to prepare student paramedics for the mental health challenges associated with a career in the emergency medical services.Aim:To explore the preparedness of student paramedics for the mental health challenges of the paramedic profession and identify the coping strategies used by veteran paramedics to successfully meet these challenges.Methods:Twenty semi-structured interviews with veteran paramedics from Australia and New Zealand were conducted.Results:Advice from veteran paramedics was comprised of three key themes: support, health, and the profession.Discussion:The findings of the study indicate that the preparation of student paramedics for the mental health challenges of the paramedic profession throughout the undergraduate curriculum could be advantageous. The advice offered by veteran paramedics can be included within undergraduate paramedic curricula and delivered by sharing the personal experiences of the veteran paramedics. These experiences are highly credible and sharing them offers an opportunity for veterans to contribute positively to the future of paramedicine. Guidelines for their inclusion in the undergraduate paramedic curriculum should be prepared to facilitate knowledge translation and to encourage the development of conscious coping strategies by student paramedics during their learning phase. Further research is needed to raise awareness in this area, with a specific focus on preparing paramedic students to cope with mental health challenges related to undergraduate degree programs, and how they feel about commencing their career as a paramedic.
5
Gallagher, Ann, Emma Vyvyan, Joan Juniper, Verity Snook, Claire Horsfield, Andy Collen, and Stuart Rutland. "Professionalism in paramedic practice: the views of paramedics and paramedic students." British Paramedic Journal 1, no. 2 (September 1, 2016): 1–8. http://dx.doi.org/10.29045/14784726.2016.1.2.1.
Full text
6
Soekiswati, Siti. "STUDI KTIRIS PRAKTIK DOKTEROID PARAMEDIS PADA PELAYANAN KESEHATAN." Media Keadilan: Jurnal Ilmu Hukum 10, no. 2 (October 31, 2019): 111. http://dx.doi.org/10.31764/jmk.v10i2.1968.
Full textAbstract:
The chaotic health services due to paramedical doctoroid practices have an impact on legal and humanitarian issues. The existence of violation of the law by paramedic doctoroid actors is inseparable from the weakness of the legal system and structure in the world of medical health. This study aims to uncover paramedics who practice doctoroid practice on independent practice. Using the type of sociological legal research (sociolegal-research) that is descriptive analytical, with a critical study approach. Analysis of the results of the study showed that the practice of paramedic physoids was caused by the legal system starting from the substance of the law, legal structure and pathological legal culture. The types of physician practices carried out by paramedics include the practices of the authority of general practitioners, pediatricians, gynecologists, internists, cardiologists, dermatologists, surgeons and dentists. Doctoroid practice is a sub-standard health service which is actually a form of violation of the law in medical practice. Based on these conditions, then the form of transcendental-based legal protection as a solution. Transcendental-based legal protection is a preventive legal protection aimed at establishing a true legal perspective as a result of the process of internalizing divine revelation which is then objectified in the character of legal actors.Keywords: legal protection, paramedic doctoroid practice, transcendentalABSTRAKCarut marutnya pelayanan kesehatan akibat praktik dokteroid paramedis berdampak kepada persoalan hukum dan kemanusiaan. Adanya pelanggaran hukum oleh pelaku dokteroid paramedis tidak terlepas dari lemahnya sistem dan struktur hukum yang ada di dunia kesehatan medis. Penelitian ini bertujuan untuk mengungkap paramedis yang melakukan praktik dokteroid pada praktik mandiri. Menggunakan jenis penelitian yuridis sosiologis (sociolegal-research) yang bersifat deskriptif analitis, dengan pendekatan studi kritis. Analisis dari hasil penelitian menunjukkan bahwa praktik dokteroid paramedis disebabkan karena sistem hukum mulai dari substansi hukum, struktur hukum dan budaya hukum yang patologis. Jenis praktik dokter yang dilakukan oleh paramedis, berupa praktik kewenangan dokter umum, spesialis anak, ginekologis, internis, cardiologis, dermatologis, spesialis bedah maupun dokter gigi. Praktik dokteroid merupakan pelayanan kesehatan substandar yang sebenarnya adalah bentuk pelanggaran hukum dalam praktik kedokteran. Atas dasar kondisi tersebut, maka bentuk perlindungan hukum berbasis transendental sebagai solusi. Perlindungan hukum berbasis transendental merupakan perlindungan hukum preventif bertujuan terbentuknya perspektif hukum yang benar sebagai hasil proses internalisasi wahyu ilahiah yang kemudian terobjektifikasi dalam karakter para pelaku hukum.Kata Kunci: perlindungan hukum, praktik dokteroid paramedis, transendental
7
Edwards, Judith, Melaine Coward, and Nicola Carey. "Paramedic independent prescribing in primary care: seven steps to success." Journal of Prescribing Practice 2, no. 6 (June 2, 2020): 292–99. http://dx.doi.org/10.12968/jprp.2020.2.6.292.
Full textAbstract:
Paramedic practice is evolving and the number of advanced paramedics in primary care roles in the UK has risen dramatically. Recent legislation granting paramedics independent prescribing rights means UK paramedics are the first worldwide to receive this extension in scope of practice – a significant milestone for the paramedic profession. Paramedic prescribing capability is expected to increase autonomy for independent case management and enhance capacity for service development. However, local and national success is likely to depend on skilful implementation and avoidance of historical barriers. This article aims to raise awareness of potential barriers to early adoption of paramedic independent prescribing in primary care. It identifies common pitfalls prior to training and provides seven practical steps for paramedics considering pursuing non-medical prescribing training.
8
Rehman, Inayat Ur. "PARAMEDICAL SERVICES IN MODERN HEALTH CARE SYSTEM." Journal of Wazir Muhammad Institute of Paramedical Technology 1, no. 1 (August 1, 2021): 1. http://dx.doi.org/10.37762/jwmipt.7.
Full textAbstract:
A paramedic or health care provider is a health professional that provides rapid response, emergency medical assessment, treatment and care to critically ill patients1. The word Paramedic is a combination of two words; para means "along the side of" and medic means "physician", so a paramedic works as an extender of the physician. He works under the direct supervision of a medical expert and is considered a “delegated practitioner”.
Paramedical service is crucial for the effective running of the modern health care system and is the lifeline of the health sector2. Paramedics are trained, equipped and required to give emergency services not just in form of first aids, but may also include medical attention that may not warrant taking the patients to the hospital3. Over the past decade, paramedic scope of practice and clinical responsibilities has expanded significantly. Advanced clinical interventions previously carried out by physicians such as ultrasound, thoracotomy and endotracheal intubation are now becoming part of the health care professional. This concentrated experience in the use of highly technical, mechanical and electronic equipment and their availability to the patient make such personnel indispensable as assistants to physicians4.
The dynamic nature of paramedics in terms of clinical practice demands continuous recognition and evaluation of the literature. Active research is essential for the translation of evidence into practice and education and is an integral part of the modern paramedic programs offered within higher education institutions. Thus there is an urgent need to launch a peer review journal in the field of paramedics that will publish high standard scientific articles and will be available to researchers and institutes. The scope of this journal includes both basic and clinical research including original articles, reviews, clinical case presentations and case reports. It aims to contribute to a better understanding of the disease and provide a reference for health professionals and researchers.
9
Jensen, J. L., A. Bienkowski, A. H. Travers, L. A. Calder, M. Walker, W. Tavares, and P. Croskerry. "A Survey to Determine Decision-Making Styles of Working Paramedics and Student Paramedics." CJEM 18, no. 3 (February 2, 2016): 213–22. http://dx.doi.org/10.1017/cem.2015.95.
Full textAbstract:
AbstractObjectiveTwo major processes underlie human decision-making: experiential (intuitive) and rational (conscious) thinking. The predominant thinking process used by working paramedics and student paramedics to make clinical decisions is unknown.MethodsA survey was administered to ground ambulance paramedics and to primary care paramedic students. The survey included demographic questions and the Rational Experiential Inventory-40, a validated psychometric tool involving 40 questions. Twenty questions evaluated each thinking style: 10 assessed preference and 10 assessed ability to use that style. Responses were provided on a five-point Likert scale, with higher scores indicating higher affinity for the style in question. Analysis included both descriptive statistics and t tests to evaluate differences in thinking style.ResultsThe response rate was 88.4% (1172/1326). Paramedics (n=904) had a median age of 36 years (IQR 29–42) and most were male (69.5%) and primary or advanced care paramedics (PCP=55.5%; ACP=32.5%). Paramedic students (n=268) had a median age of 23 years (IQR 21–26), most were male (63.1%) and had completed high school (31.7%) or an undergraduate degree (25.4%) prior to paramedic training. Both groups scored their ability to use and favourability toward rational thinking significantly higher than experiential thinking. The mean score for rational thinking was 3.86/5 among paramedics and 3.97/5 among paramedic students (p<0.001). The mean score for experiential thinking was 3.41/5 among paramedics and 3.35/5 among paramedic students (p=0.06).ConclusionWorking paramedics and student paramedics prefer and perceive that they have the ability to use rational over experiential thinking. This information adds to our current knowledge on paramedic decision-making and is potentially important for developing continuing education and clinical support tools.
10
O’Meara, Peter, Gary Wingrove, and Michael Nolan. "Clinical leadership in paramedic services: a narrative synthesis." International Journal of Health Governance 22, no. 4 (December 4, 2017): 251–68. http://dx.doi.org/10.1108/ijhg-03-2017-0014.
Full textAbstract:
Purpose In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation. Design/methodology/approach This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications. Findings Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics. Originality/value The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.
11
Kelton, D., S. Doran, M. Davis, K. Van Aarsen, and J. Momic. "P093: Evaluating factors related to effective interpersonal communication during mandatory paramedic patches." CJEM 22, S1 (May 2020): S98. http://dx.doi.org/10.1017/cem.2020.299.
Full textAbstract:
Introduction: Delegation of controlled medical acts by physicians to paramedics is an important component of the prehospital care framework. Where directives indicate that physician input is needed before proceeding with certain interventions, online medical control (a “patch”) exists to facilitate communication between a paramedic and a Base Hospital Physician (BHP) to request an order to proceed with that intervention. Many factors contribute to success or failure of effective interpersonal communication during a patch call. The aim of this study was to examine areas of potential improvement in communication between paramedics and physicians during the patch call. Methods: Prehospital paramedic calls that included a mandatory patch point (excluding requests for termination of resuscitation and those records which were unavailable) were identified through review of all patch records from January 1, 2014 to December 31, 2017 for Paramedic Services in our region. Written Ambulance Call Reports (ACRs) and audio recordings of paramedic patches were obtained and reviewed. Pre-specified time intervals, clinical factors, specific patch requests and resulting orders from the BHP to the paramedics were extracted. Differences between groups were compared using t-tests. Results: 214 records were initially identified and screened. 91 ACRs and audio patch records were included in the analysis. 51/91 (56%) of patch order requests for interventions were granted by the BHP. Clarification of information provided by the paramedic or reframing of the paramedic's request was required less often, but not statistically significant, in calls ultimately resulting in granted requests versus those that were not granted (mean 1.4 versus 1.7, Δ-0.28; 95% CI -0.75-0.18 p = 0.64). The mean time from first contact with the BHP to statement of the request was similar in patches where the request was granted and not granted (44.9 versus 46.3, Δ-1.4; 95% CI -12.9-10.2, p = 0.49). Conclusion: The communication between BHPs and paramedics is an important and under-investigated component of prehospital emergency care. This retrospective review presents some novel targets for further research and potential education in patch communication to improve efficiency and quality of prehospital care for patients.
12
Armour, Richard, Jennie Helmer, and John Tallon. "Paramedic-delivered teleconsultations: a grounded theory study." Canadian Journal of Emergency Medicine 24, no. 2 (December 7, 2021): 167–73. http://dx.doi.org/10.1007/s43678-021-00224-6.
Full textAbstract:
Abstract Objective Progression in Anglo-American models of out-of-hospital care has resulted in the development of alternative roles for paramedics, including advanced paramedics providing teleconsultations to frontline paramedics. Traditionally provided by physicians, little is known about how paramedics perceive peer-to-peer teleconsultations. This research aimed to explore paramedic perceptions of paramedic-delivered teleconsultations. Methods This investigation employed a constructivist grounded theory methodology. Six focus groups were conducted with purposive and theoretical sampling and data analyzed using open coding and continual comparative analysis. Results 33 paramedics from across British Columbia, Canada, participated in the focus groups. Seven key themes emerged during the focus groups; the perceived roles and status of paramedic specialists and physicians in healthcare, the influence of relationships and culture on clinical consultations, practicalities of out-of-hospital care and the importance of lived experience, provision of appropriate clinical advice, professional trust and respect, mentorship in out-of-hospital care and clinical governance and education requirements. This led to the development of the grounded theory paramedics increasing ownership of their profession. Conclusion Paramedics reported a number of areas in which paramedic-delivered teleconsultations provided benefits not seen with traditional physician-delivered teleconsultation model. Emergency health systems delivering an Anglo-American model of care should consider the possible benefits of paramedic-delivered teleconsultations.
13
Fraess-Phillips, Alex J. "Can Paramedics Safely Refuse Transport of Non-Urgent Patients?" Prehospital and Disaster Medicine 31, no. 6 (September 19, 2016): 667–74. http://dx.doi.org/10.1017/s1049023x16000935.
Full textAbstract:
AbstractObjectiveThe goal of this search was to review the current literature regarding paramedic triage of primary care patients and the safety of paramedic-initiated non-transport of non-urgent patients.MethodsA narrative literature review was conducted using the Medline (Medline Industries, Inc.; Mundelein, Illinois USA) database and a manual search of Google Scholar (Google; Mountain View, California USA).ResultsOnly 11 studies were found investigating paramedic triage and safety of non-transport of non-urgent patients. It was found that triage agreement between paramedic and emergency department staff generally is poor and that paramedics are limited in their abilities to predict the ultimate admission location of their patients. However, these triage decisions and admission predictions are much more accurate when the patient’s condition is the result of trauma and when the patient requires critical care services. Furthermore, the literature provides very limited support for the safety of paramedic triage in the refusal of non-urgent patient transport, especially without physician oversight. Though many non-transported patients are satisfied with the quality of non-urgent treatment that they receive from paramedics, the rates of under-triage and subsequent hospitalization reported in the literature are too high to suggest that this practice can be adopted widely.ConclusionThere is insufficient evidence to suggest that non-urgent patients can safely be refused transport based on paramedic triage alone. Further attempts to implement paramedic-initiated non-transport of non-urgent patients should be approached with careful triage protocol development, paramedic training, and pilot studies. Future primary research and systematic reviews also are required to build on the currently limited literature.Fraess-PhillipsAJ. Can paramedics safely refuse transport of non-urgent patients?Prehosp Disaster Med. 2016;31(6):667–674.
14
O’Meara, Peter, Gary Wingrove, and Michael McKeage. "Self-regulation and medical direction." International Journal of Health Governance 23, no. 3 (September 3, 2018): 233–42. http://dx.doi.org/10.1108/ijhg-02-2018-0006.
Full textAbstract:
Purpose The purpose of this paper is to describe and analyse two approaches to paramedic service clinical governance and quality management from the perspective of two groups of paramedics and paramedic managers working in North America. Design/methodology/approach A case study approach was utilised to describe and analyse paramedic service medical direction in North America and contrast this with the professional self-governance and clinical governance systems operating in other high-income countries. Researchers interviewed participants at two remote North American sites, then completed transcription and thematic analysis. Findings Participants identified three themes: first, resourcing, regulatory frameworks and fragmentation; second, independent practice facilitators and barriers; and third, paramedic roles and professionalisation. Those trained outside North America tended to identify self-regulation and clinical governance as the preferred approach to quality management. Few participants had considered paramedicine becoming a self-regulating health profession. Originality/value In North America, the “medical direction” model is the dominant approach employed to ensure optimal patient outcomes in paramedic service delivery. In contrast, other comparable countries employ paramedic self-regulatory systems combined with clinical governance to achieve the same ends. This is one of two studies to examine medical direction from the perspective of paramedics and paramedic managers.
15
Somers, Anna. "Are paramedic graduates effectively prepared for death? A scoping review." Journal of Paramedic Practice 13, no. 10 (October 2, 2021): 408–13. http://dx.doi.org/10.12968/jpar.2021.13.10.408.
Full textAbstract:
Paramedics often come across death because of the nature of their work. Attending an incident involving the death of a patient could affect a paramedic's mental health. A scoping literature review surrounding the readiness and education regarding death in the prehospital setting for paramedic students was carried out. Given the potential impact upon practitioner mental health, the review aimed to determine the quality and extent of new research regarding education in death for paramedics. Four themes arose from the review: inadequate preparation; methods of death education; improved confidence; and implications for more research.
16
Somers, Anna. "Are paramedic graduates effectively prepared for death? A scoping review." Journal of Paramedic Practice 13, no. 10 (October 2, 2021): 408–13. http://dx.doi.org/10.12968/jpar.2021.13.10.408.
Full textAbstract:
Paramedics often come across death because of the nature of their work. Attending an incident involving the death of a patient could affect a paramedic's mental health. A scoping literature review surrounding the readiness and education regarding death in the prehospital setting for paramedic students was carried out. Given the potential impact upon practitioner mental health, the review aimed to determine the quality and extent of new research regarding education in death for paramedics. Four themes arose from the review: inadequate preparation; methods of death education; improved confidence; and implications for more research.
17
Smith, Erin, Frederick M. Burkle, Kristine Gebbie, David Ford, and Cécile Bensimon. "Acceptable Limitations on Paramedic Duty to Treat During Disaster: A Qualitative Exploration." Prehospital and Disaster Medicine 33, no. 5 (October 2018): 466–70. http://dx.doi.org/10.1017/s1049023x18000857.
Full textAbstract:
AbstractIntroductionThe Australian prehospital profession has not yet facilitated a comprehensive discussion regarding paramedic role and responsibility during disasters. Whether paramedics have a duty to treat under extreme conditions and what acceptable limitations may be placed on such a duty require urgent consideration. The purpose of this research is to encourage discussion within the paramedic profession and broader community on this important ethical and legal issue.MethodsThe authors employed qualitative methods to gather paramedic and community member perspectives in Victoria, Australia.ResultsThese findings suggested that both paramedic and community member participants agree that acceptable limitations on paramedic duty to treat during disaster are required. These limitations should be based on consideration of the following factors: personal health circumstances (eg, pregnancy for female paramedics); pre-existing mental health conditions (eg, posttraumatic stress disorder/PTSD); competing personal obligations (eg, paramedics who are single parents); and unacceptable levels of personal risk (eg, risk of exposure and infection during a pandemic).ConclusionIt is only with the engagement of a more broadly representative segment of the prehospital profession and greater Australian community that appropriate guidance on limiting standards of care under extreme conditions can be developed and integrated within prehospital care in Australia.SmithE, BurkleFM Jr., GebbieK, FordD, BensimonC. Acceptable limitations on paramedic duty to treat during disaster: a qualitative exploration. Prehosp Disaster Med. 2018;33(5):466–470.
18
Best, Pete, and Vanessa Taylor. "Paramedic prescribing: implementation in practice." Journal of Paramedic Practice 13, no. 1 (January 2, 2021): 14–23. http://dx.doi.org/10.12968/jpar.2021.13.1.14.
Full textAbstract:
Background: In April 2018, legislation was changed to allow paramedics to prescribe independently. There is limited research regarding how paramedics are implementing their prescribing qualification. Policy papers and other literature were largely written before April 2018 and therefore document expectations regarding prescribing paramedics within the healthcare system. Aim: To explore if paramedic prescribing is being practised as expected. This article reports part of a larger study that explored how paramedics are implementing their prescribing qualification in practice more broadly. Methods: A web-based survey was conducted using convenience sampling. The sample represents 14.65% of the total number of prescribing paramedics. Findings: Paramedics are working in a variety of areas of healthcare. Some paramedics do not have the required amount of experience or the educational background recommended to become a prescribing paramedic. It is unlikely that new pathways to care are being created by prescribing paramedics. It is unclear whether prescribing increases patient access to medications.
19
Best, Pete, and Vanessa Taylor. "Paramedic prescribing: implementation in practice." Journal of Paramedic Practice 13, no. 1 (January 2, 2021): 14–23. http://dx.doi.org/10.12968/jpar.2021.13.1.14.
Full textAbstract:
Background: In April 2018, legislation was changed to allow paramedics to prescribe independently. There is limited research regarding how paramedics are implementing their prescribing qualification. Policy papers and other literature were largely written before April 2018 and therefore document expectations regarding prescribing paramedics within the healthcare system. Aim: To explore if paramedic prescribing is being practised as expected. This article reports part of a larger study that explored how paramedics are implementing their prescribing qualification in practice more broadly. Methods: A web-based survey was conducted using convenience sampling. The sample represents 14.65% of the total number of prescribing paramedics. Findings: Paramedics are working in a variety of areas of healthcare. Some paramedics do not have the required amount of experience or the educational background recommended to become a prescribing paramedic. It is unlikely that new pathways to care are being created by prescribing paramedics. It is unclear whether prescribing increases patient access to medications.
20
Williams, Brett, Mal Boyle, and Tracy Earl. "Measurement of Empathy Levels in Undergraduate Paramedic Students." Prehospital and Disaster Medicine 28, no. 2 (January 29, 2013): 145–49. http://dx.doi.org/10.1017/s1049023x1300006x.
Full textAbstract:
AbstractIntroductionParamedics rely on establishing a health provider-patient relationship with patients that promotes two-way communication, patient satisfaction, and facilitates appropriate patient assessment and treatment. Paramedics also must have an ability to empathize with patients and their family members in order to develop a successful health provider-patient relationship. The objective of this study was to assess paramedics’ empathy and attitudes toward patients with specific conditions.MethodsThis was a cross-sectional study using a convenience sample of first-, second-, and third-year, Australian undergraduate paramedic students. Student empathy levels were assessed using two standardized self-reporting instruments: the Jefferson Scale of Physician Empathy (JSPE) Health Professional (HP) version and the Medical Condition Regard Scale (MCRS).ResultsA total of 94 paramedic students participated in the study. The JSPE demonstrated that male paramedic students had higher mean empathy scores than did female paramedic students (113.25 and 107.5, respectively; P = .042). The JSPE empathy level scores were lowest among first-year paramedic students (mean = 107.53); age was not found to be a significant variable on empathy scores. The Medical Condition Regard Scale revealed lowest scores in compassion towards substance abuse (mean = 46.42).ConclusionsThe results of this study provide the discipline of paramedic health care with useful data, and provide students, academics, and other educators with important information regarding the improvement of the health provider-patient relationship and paramedic education curriculum development.WilliamsB, BoyleM, EarlT. Measurement of empathy levels in undergraduate paramedic students. Prehosp Disaster Med. 2013;28(2):1-5.
21
Shannon, Brendan, Sascha Baldry, Peter O’Meara, Nicole Foster, Angela Martin, Matthew Cook, Karen Stewart, and Alecka Miles. "The definition of a community paramedic: An international consensus." Paramedicine 20, no. 1 (January 2023): 4–22. http://dx.doi.org/10.1177/27536386221148993.
Full textAbstract:
Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A total of 94 community paramedicine experts were identified and 76 experts consented to involvement in this Delphi. Response rate ranged from 81.6% (Phase 1) to 63.1% (Phase 2). Participants expressed the importance of community paramedic definition having components attributed to primary health care, health promotion, chronic disease management and advanced clinical assessment. Participants expressed that these are essential components of the community paramedic skill set, which distinguishes the role from other frontline paramedics. A final consensus with 91% agreement on the definition of a community paramedic was achieved. The four-phase Delphi achieved consensus on the definition of a community paramedic as follows: A community paramedic provides person-centred care in a diverse range of settings that address the needs of the community. Their practice may include the provision of primary health care, health promotion, disease management, clinical assessment and needs-based interventions. They should be integrated with interdisciplinary healthcare teams which aim to improve patient outcomes through education, advocacy and health system navigation. The adoption of the global consensus on the definition of a community paramedic will enhance efforts to promote the value of this specialist role, enabling a better understanding of how a community paramedic contributes to the wider healthcare system. [Media: see text]
22
Pavoni, Katie, and Louise Phillips. "‘Giving a piece of you’: the lecturer experience of aiding student wellbeing." Journal of Paramedic Practice 14, no. 5 (May 2, 2022): 188–96. http://dx.doi.org/10.12968/jpar.2022.14.5.188.
Full textAbstract:
Background: The mental health of ambulance clinicians is a national priority. For student paramedics, the risk and inherent vulnerability to poor mental wellbeing are significant. However, evidence exploring support in universities for paramedic students and the role of academic faculty in this within paramedic preregistration programmes is limited. Aims: To explore the experiences and perceptions of university lecturers towards supporting student paramedic wellbeing. Methods: A qualitative research design was adopted to explore the experiences of six paramedic senior lecturers from three urban universities. Data were collected via semi-structured interviews and thematically analysed using interpretative phenomenological analysis. Findings: Themes of ‘navigating the professional role,’ ‘the whole student’, ‘enabling cultural change’ and ‘supporting resilience and preparedness for practice’ were identified. Conclusions: University lecturers play a crucial role in student paramedic wellbeing and the unique role and identity of paramedic academics should be embraced. Paramedic programmes should consider a proactive approach to emotional health within the curriculum, alongside peer support, student-centred initiatives and tailored trauma support.
23
Dixon, Matt. "Non-medical prescribing for paramedics in primary care." Journal of Paramedic Practice 13, no. 4 (April 2, 2021): 140–43. http://dx.doi.org/10.12968/jpar.2021.13.4.140.
Full textAbstract:
As paramedic roles continue to grow and diversity, the number of paramedics working in primary care is on the rise. Knowledge of non-medical prescribing specifically for paramedics in these settings is necessary, as are new frameworks for medicines management beyond the ambulance services and for general practice in particuar. This instalment in the Prescribing Paramedic series discusses prescribing in primary care settings including some of the more practical aspects of relevance to paramedics.
24
Smith, Erin, Frederick Burkle, Kristine Gebbie, David Ford, and Cécile Bensimon. "A Qualitative Study of Paramedic Duty to Treat During Disaster Response." Disaster Medicine and Public Health Preparedness 13, no. 02 (April 10, 2018): 191–96. http://dx.doi.org/10.1017/dmp.2018.15.
Full textAbstract:
AbstractObjectivesDisasters place unprecedented demands on emergency medical services and can test paramedics personal commitment as health care professionals. Despite this challenge, guidelines and codes of ethics are largely silent on the issue, providing little to no guidance on what is expected of paramedics or how they ought to approach their duty to treat in the face of risk. The objective of this research is to explore how paramedics view their duty to treat during disasters.MethodsThe authors employed qualitative methods to gather Australian paramedic perspectives.ResultsOur findings suggest that paramedic decisions around duty to treat will largely depend on individual perception of risk and competing obligations. A code of ethics for paramedics would be useful, but ultimately each paramedic will interpret these suggested guidelines based on individual values and the situational context.ConclusionsComing to an understanding of the legal issues involved and the ethical-social expectations in advance of a disaster may assist paramedics to respond willingly and appropriately. (Disaster Med Public Health Preparedness. 2019;13:191–196)
25
Edwards, Dale. "Paramedic preceptor: work readiness in graduate paramedics." Clinical Teacher 8, no. 2 (May 17, 2011): 79–82. http://dx.doi.org/10.1111/j.1743-498x.2011.00435.x.
Full text
26
Wacht, O., K. Dopelt, N. Davidovitch, D. Schwartz, and A. Goldberg. "(A313) Integrating Paramedics into the Health System — Israel as a Case Study." Prehospital and Disaster Medicine 26, S1 (May 2011): s88. http://dx.doi.org/10.1017/s1049023x11002974.
Full textAbstract:
BackgroundSince its development in the 1970s, the paramedic profession has tried to expend its traditional role of providing prehospital emergency care in ambulances into new fields of practice (e.g. community care). Paramedics in Israel are employed almost exclusively in the emergency medical services (EMS). Similar to other countries, the manpower shortage in the Israeli health system forced policy-makers to consider the expansion of traditional roles of various healthcare professions including paramedics.ObjectivesThis presentation seeks to: (1) map the current situation and challenges facing paramedics in Israel; (2) examine paramedics' professional status among policy-makers; and (3) examine the best way to integrate paramedics in the Israeli health-system.MethodsQualitative interviews were conducted with 20 senior policy-makers in the Israeli EMS system, Academia, Health Ministry, and military. A policy analysis of documents, laws, regulations, and public media was conducted.ResultsThe Ministry of Health in Israel did not play a significant role in the regulation of the profession. Nevertheless, according to the interviewees, paramedics have gained considerable professional recognition among policy-makers, healthcare professionals, and the general public. Following the medical manpower crisis that is evolving in Israel, and the trends that are common in many western countries of expanding the traditional roles of allied health professions, most policy-makers in Israel see the paramedic role evolving into new field of practice. According to policy-makers, legislators, and EMS officials, the major challenges that the paramedic profession faces deal with legislative and professional (mainly academization) issues.ConclusionsThe paramedic profession must adapt itself to the new medical environment. More research should be conducted to build a model, adapted for different local national context, to expand the traditional role of paramedics. This will influence training, research and policy-making regarding the paramedic profession, and will change the traditional professional medical borders.
27
Grevin, Francine. "Posttraumatic Stress Disorder, Ego Defense Mechanisms, and Empathy among Urban Paramedics." Psychological Reports 79, no. 2 (October 1996): 483–95. http://dx.doi.org/10.2466/pr0.1996.79.2.483.
Full textAbstract:
Although numerous studies have indicated that paramedics experience high occupational stress, there has been a lack of research addressing the mental health implications of this elevated stress on these emergency workers. Related constructs such as the coping mechanisms and personality characteristics of paramedics have also been neglected. Groups of experienced paramedics ( n = 120) and paramedic students ( n = 105) were, therefore, assessed for Posttraumatic Stress Disorder, the extent and mode of ego defense utilization, and empathy. Analyses indicated that 20% of the experienced paramedics and 22% of the paramedic students appear to be suffering from trauma as measured by the MMPI-2 PK Scale. Denial and Repression scores were significantly high compared to normative samples for both groups, while Regression and Reaction Formation scores were significantly low. Both the paramedics and paramedic students had significantly low scores on Empathy. It is suggested that paramedics may be predisposed to these personality traits and that high denial and low empathy serve as functionally adaptive mechanisms in a chronically stressful work environment.
28
Leduc, S., G. Wells, V. Thiruganasambandamoorthy, Z. Cantor, P. Kelly, M. Rietschlin, and C. Vaillancourt. "LO20: The characteristics, clinical course and disposition of long-term care patients treated by paramedics during an emergency call: Exploring the potential impact of community paramedicine." CJEM 22, S1 (May 2020): S14. http://dx.doi.org/10.1017/cem.2020.76.
Full textAbstract:
Introduction: An increasing number of Canadian paramedic services are creating Community Paramedic programs targeting treatment of long-term care (LTC) patients on-site. We explored the characteristics, clinical course and disposition of LTC patients cared for by paramedics during an emergency call, and the possible impact of Community Paramedic programs. Methods: We completed a health records review of paramedic call reports and emergency department (ED) records between April 1, 2016 and March 31, 2017. We utilized paramedic dispatch data to identify emergency calls originating from LTC centers resulting in transport to one of the two EDs of the Ottawa Hospital. We excluded patients with absent vital signs, a Canadian Triage and Acuity Scale (CTAS) score of 1, and whose transfer to hospital were deferrable or scheduled. We stratified remaining cases by month and selected cases using a random number generator to meet our apriori sample size. We collected data using a piloted standardized form. We used descriptive statistics and categorized patients into groups based on the ED care received and if the treatment received fit into current paramedic medical directives. Results: Characteristics of the 381 included patients were mean age 82.5 years, 58.5% female, 59.7% hypertension, 52.6% dementia and 52.1% cardiovascular disease. On arrival at hospital, 57.7% of patients waited in offload delay for a median time of 45 minutes (IQR 33.5-78.0). We could identify 4 groups: 1) Patients requiring no treatment or diagnostics in the ED (7.9%); 2) Patients receiving ED treatment within current paramedic medical directives and no diagnostics (3.2%); 3) Patients requiring diagnostics or ED care outside current paramedic directives (54.9%); and 4) patients requiring admission (34.1%). Most patients were discharged from the ED (65.6%), and 1.1% died. The main ED diagnoses were infection (18.6%) and musculoskeletal injury (17.9%). Of the patients that required ED care but were discharged, 64.1% required x-rays, 42.1% CT, and 3.4% ultrasound. ED care included intravenous fluids (35.7%), medication (67.5%), antibiotics (29.4%), non-opioid analgesics (29.4%) and opioids (20.7%). Overall, 11.1% of patients didn't need management beyond current paramedic capabilities. Conclusion: Many LTC patients could receive care by paramedics on-site within current medical directives and avoid a transfer to the ED. This group could potentially grow using Community Paramedics with an expanded scope of practice.
29
Barry, Tomás, Alan Batt, Gina Agarwal, Matthew Booker, Mary Casey, and Geoff McCombe. "Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives." HRB Open Research 5 (August 12, 2022): 40. http://dx.doi.org/10.12688/hrbopenres.13545.2.
Full textAbstract:
Background: Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods: We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results: Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GPs, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GPs, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions: The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
30
Barry, Tomás, Alan Batt, Gina Agarwal, Matthew Booker, Mary Casey, and Geoff McCombe. "Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives." HRB Open Research 5 (May 23, 2022): 40. http://dx.doi.org/10.12688/hrbopenres.13545.1.
Full textAbstract:
Background: Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods: We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results: Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GP’s, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GP’s, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions: The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
31
Green, Robert S., Andrew H. Travers, Edward Cain, Samuel G. Campbell, Jan L. Jensen, David A. Petrie, Mete Erdogan, Gredi Patrick, and Ward Patrick. "Paramedic Recognition of Sepsis in the Prehospital Setting: A Prospective Observational Study." Emergency Medicine International 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/6717261.
Full textAbstract:
Background. Patients with sepsis benefit from early diagnosis and treatment. Accurate paramedic recognition of sepsis is important to initiate care promptly for patients who arrive by Emergency Medical Services.Methods. Prospective observational study of adult patients (age ≥ 16 years) transported by paramedics to the emergency department (ED) of a Canadian tertiary hospital. Paramedic identification of sepsis was assessed using a novel prehospital sepsis screening tool developed by the study team and compared to blind, independent documentation of ED diagnoses by attending emergency physicians (EPs). Specificity, sensitivity, accuracy, positive and negative predictive value, and likelihood ratios were calculated with 95% confidence intervals.Results. Overall, 629 patients were included in the analysis. Sepsis was identified by paramedics in 170 (27.0%) patients and by EPs in 71 (11.3%) patients. Sensitivity of paramedic sepsis identification compared to EP diagnosis was 73.2% (95% CI 61.4–83.0), while specificity was 78.8% (95% CI 75.2–82.2). The accuracy of paramedic identification of sepsis was 78.2% (492/629, 52 true positive, 440 true negative). Positive and negative predictive values were 30.6% (95% CI 23.8–38.1) and 95.9% (95% CI 93.6–97.5), respectively.Conclusion. Using a novel prehospital sepsis screening tool, paramedic recognition of sepsis had greater specificity than sensitivity with reasonable accuracy.
32
Nakata, Keiji. "Triage Problem Among the Ambulance Crew (Paramedic) in Japan." Prehospital and Disaster Medicine 34, s1 (May 2019): s173. http://dx.doi.org/10.1017/s1049023x19003972.
Full textAbstract:
Introduction:At various accidents or disaster sites, rescue, first aid, and transport to hospitals has been provided by ambulance crews (paramedics). In the case of mass casualties, they also need to operate triage for injured people.Aim:To consider and reveal challenges in triage by ambulance crews (paramedics) on-site.Methods:Interviews of seven ambulance crews (paramedics) and their instructors were conducted and their answers were analyzed.Results:(1.) Triage black tags: declaring “deceased: not able to survive” might give a heavy mental burden and psychological responsibility. Legal protection and an interstitial rule will be necessary in the future. (2.) Missed triage: the ambulance crew cannot perform a triage that may develop a legal problem. It is always important to prevent ambulance crews from being charged. (3.) Triage education and training: there are few triage trainings at fire departments although the number of emergency medical responses is increasing compared to fire response. It will be necessary to increase time of the triage education and training in near future. (4.) Command system (characteristic rank system in the fire department): There is a problem with the rank system in fire departments since confusion occurs when a commander of the First Aid Station is not a licensed paramedic. The ambulance crew (paramedic) usually consists of the three different ranked people. Individual operations are difficult during operation. Education for the paramedic executive is necessary for the fire organization.Discussion:For the triage by ambulance crew (paramedic), legal protection by medical control operation is required, and it may lead to a reduction of heavy mental burden. Triage training is needed to improve the training of triage. The ambulance crew (paramedic) operates under the fire department command system. However, at the time of disaster, the ambulance crew (paramedic) should also work under the medical command system.
33
King, Shannon C., Amanda L. Rebar, Paul Oliveri, and Robert Stanton. "Australian paramedic students’ mental health literacy and attitudes towards mental health." Journal of Mental Health Training, Education and Practice 17, no. 1 (October 11, 2021): 61–72. http://dx.doi.org/10.1108/jmhtep-03-2021-0027.
Full textAbstract:
Purpose Australian paramedics regularly encounter patients experiencing mental illness. However, some paramedics hold negative attitudes towards the use of emergency services in providing care for these patients. Thus, the purpose of the present study was to examine the mental health literacy (MHL) of Australian paramedic students, and the training and experiential factors associated with MHL. Design/methodology/approach A cross-sectional online survey was delivered to paramedic students across Australia. A total of 94 paramedic students completed the survey examining MHL, mental health first aid (MHFA) intentions, confidence in providing help, personal and perceived stigma and willingness to interact with a person experiencing mental illness. Findings Participants generally had poor MHFA intentions in spite of good recognition of mental health disorders and good knowledge about mental health. Participants also demonstrated low stigmatising attitudes towards mental illness; however, they expressed a lack of willingness to interact with a person experiencing mental illness. Originality/value Our findings propose a combination of work-based experience and specific MHFA training may be beneficial to paramedic students to improve care for patients experiencing mental illness.
34
Boyer, Christopher. "High-fidelity simulation and student performance in the Capstone Field Internship." International Paramedic Practice 9, no. 4 (December 2, 2019): 84–89. http://dx.doi.org/10.12968/ippr.2019.9.4.84.
Full textAbstract:
Despite the increased use of high-fidelity simulation in the education of paramedics, little research has been done into its impact on paramedic student performance. The objective of this quasi-experimental quantitative analysis was to investigate differences in the performance of students in the paramedic field internship between those trained using low-fidelity and those trained using high-fidelity simulation practices. Data were derived from the student field internship records from a community college-based paramedic programme in the United States, with students in two groups: a low-fidelity simulation group (2010–2013) and a high-fidelity simulation group (2014–2017). The students in the high-fidelity simulation group required fewer patient contacts to complete the internship than the students in the low-fidelity simulation group, demonstrating a significant improvement in student performance. While further studies are required to more fully investigate the use of high-fidelity simulation in paramedic education, this study provides necessary insight into the impact of high-fidelity simulation in the training of paramedics.
35
Hutchison, Trudy, Carolyn Lees, Robyn Lotto, Alison White, and Ron Harris. "Clinical decision making and the challenges of responding to mental health needs." Journal of Paramedic Practice 11, no. 10 (October 2, 2019): 434–39. http://dx.doi.org/10.12968/jpar.2019.11.10.434.
Full textAbstract:
The paramedic service responds to emergency calls for a variety of reasons, many relating to mental health concerns. This qualitative study aims to explore the views and experiences of student paramedics in relation to clinical decision making for mental health calls. Focus groups were used to investigate the participants' perspectives. Thematic analysis was used to organise data and identify key issues. Findings suggested some disparity between what paramedic students were prepared for and the reality of public need. Clinical decision making in relation to those with mental health problems was significantly influenced by the current provision of mental health services and the lack of mental health-specific education for student paramedics. Current changes to the paramedic programme make this an opportune time for a review of curriculum content.
36
Sirotkina, O. V., T. N. Ischuk, V. A. Lapotnikov, I. S. Golubeva, E. V. Parmon, and E. V. Shlyakhto. "Qualification characteristic of a bachelor of general medicine." "Arterial’naya Gipertenziya" ("Arterial Hypertension") 26, no. 5 (December 14, 2020): 598–606. http://dx.doi.org/10.18705/1607-419x-2020-26-5-598-606.
Full textAbstract:
As defined by the World health organization, a paramedic (from German feldscher) is a medical professional who provides various medical services, limited to emergency treatment and the practice of ambulance. In Russia, on the one hand, the need for a paramedic is minimal and not relevant in big cities, on the other hand, this profession is in demand in remote areas and in rural areas due to the shortage of doctors there. This contradiction can be resolved when training a paramedic in the framework of higher education at the bachelor’s level “General medicine”. The purpose of this work was to structure the qualification characteristics of a paramedic, for which we analyzed the international experience of training and assessing the professional qualifications of a paramedic, the work functions performed by a paramedic and a general practitioner and the prospects for the development of a paramedic’s competence, prepared within the framework of the educational program bachelor’s degree “General medicine”.
37
Proctor, Alyesha. "Student paramedics' views on placements in general practice as part of a degree." Journal of Paramedic Practice 11, no. 12 (December 2, 2019): 519–25. http://dx.doi.org/10.12968/jpar.2019.11.12.519.
Full textAbstract:
Background: Frontline paramedics are increasingly attending to non-emergency problems and calls that could be managed by a primary care provider. Alongside this, there is a growing pressure to manage patients at home or use an alternative care pathway and reduce hospital conveyance. Student paramedic training, including both placement and taught elements at university, should therefore reflect this. However, placement opportunities for student paramedics in primary care settings is variable across the UK. Aim: To explore student paramedics' views on incorporating a placement within general practice as part of their degree and its effects on their learning and development as an autonomous paramedic. Method: A small pedagogic study as part of a postgraduate certificate in academic practice for higher education, involving a case study, qualitative approach using face-to-face, semi-structured interviews and thematic analysis, was carried out. Findings: Student paramedics feel that incorporating a placement in general practice as part of their degree will significantly help in their learning and development as autonomous paramedics. Specifically, they feel it: will help them understand the role of the GP and what the GP expects of them; will help them to focus their assessments and improve confidence in decisions not to convey patients; may lead to better knowledge of alternative care pathways; and, finally, may provide an insight into the role of the paramedic in general practice as a future career opportunity. There are a few reservations about whether students would be able to use the skills and knowledge gained in this setting, as they feel they do not have access to the tools or the authority in a frontline ambulance service. Students would prefer to have a placement in a GP surgery in the final year of their university degree. Conclusion: Placement within a GP surgery for student paramedics should be included as part of a paramedic science degree as a priority. This is necessary, particularly given the changing role of the contemporary paramedic who attends to non-emergency problems.
38
MClelland, Graham, Karl Charlton, and Matt Limmer. "05 The RESearch PARamedic Experience (RESPARE) study." Emergency Medicine Journal 39, no. 9 (August 23, 2022): e5.42. http://dx.doi.org/10.1136/emermed-2022-999.5.
Full textAbstract:
BackgroundThe research paramedic is a relatively niche role undertaken by a small number of paramedics who support, deliver and promote research. Research paramedic positions are often temporary due to the project-based nature of studies. The routes into research, and how to establish a research career, are not as clear as routes into other areas of practice and very little has been published about the research paramedic role. The aim of this study was to explore the experience of people who work, or have worked, as research paramedics.MethodsA generic qualitative approach underpinned by phenomenological concepts was used. Participants were recruited via ambulance research leads and social media. Online focus groups allowed participants to discuss their roles with peers who may be geographically distant. Semi-structured interviews will expand on the focus group findings. Data were analysed using framework analysis.ResultsThirteen paramedics representing nine NHS trusts participated in three focus groups in November 2021.Initial themes include: common routes into the role; delivering versus developing research; barriers and facilitators to recruitment; networking and support; and clinical credibility.Five interviews are planned for December 2021 to expand on these findings.ConclusionsFurther analysis is needed but initial findings indicate that many research paramedics have had similar experiences in terms of starting by delivering research for large studies then building on this experience and the networks they create to develop their own research. There are recognised organisational and financial barriers to working as a research paramedic. Progression beyond the research paramedic role is not very well defined but often involves building links outside of the ambulance services.
39
Ginting, Daniel, Nina Fentiana, Tiara Rajagukguk, and Harry Wahyudi. "Gaya Kepemimpinan dan Komitmen Paramedis dalam Implementasi Akreditasi Rumah Sakit Versi SNARS." Jurnal Ilmiah Universitas Batanghari Jambi 19, no. 3 (October 15, 2019): 504. http://dx.doi.org/10.33087/jiubj.v19i3.642.
Full textAbstract:
Clause 40 paragraph (1) of Law Number 44 of 2009 concerning Hospitals states that in an effort to improve the quality of hospital services, accreditation must be carried out periodically at least every three years. The leadership design is needed to support the formation of paramedic commitments in the implementation of accreditation. The research aims to identify the leadership style of direct paramedic leaders and paramedic commitment in the implementation of SNARS version accreditation. The study was designed with a cross sectional approach at Delia Hospital with a sample of 79 paramedics and using primary data obtained through observation and interviews. Correlation and simple linear regression tests showed leadership style and paramedic commitment in implementing hospital accreditation showed a strong and positive pattern of relationships. The results of the study concluded that achievement-oriented leadership style is the leadership style that is considered the most able to build paramedic commitment in the implementation of accreditation.
40
Ionov, Alexander Petrovich, Ol’ga Viktorovna Belikova, and Lyudmila Anatolyevna Lazareva. "Assessment of the psychological qualities of a paramedic’s personality." Medsestra (Nurse), no. 2 (January 28, 2022): 12–17. http://dx.doi.org/10.33920/med-05-2202-02.
Full textAbstract:
The purpose of the study is to identify professionally significant psychological qualities of a paramedic ‘s personality. Results. The presence of synchronous changes in indicators for each characteristic of the paramedic’s personality, both male and female, was revealed; the most pronounced psychological qualities of the personality of professional paramedics were: developed visual-imaginative thinking, caution and prudence, suspicion; the most pronounced psychological qualities of the personality of medical students were the same qualities as those of professional paramedics with the inclusion of markedly pronounced conservatism. Conclusion. When comparing the psychograms of professional paramedics and medical students, psychological characteristics that are subject to correction were identified: emotional instability, dominance, suspicion and relaxation.
41
Howlett, Gemma. "Nearly qualified student paramedics' perceptions of reflection and use in practice." Journal of Paramedic Practice 11, no. 6 (June 2, 2019): 258–63. http://dx.doi.org/10.12968/jpar.2019.11.6.258.
Full textAbstract:
Reflection is embedded in a variety of higher education healthcare programmes, and is a continuing professional development requirement for paramedics ( Health and Care Professions Council, 2012 ; 2014 ). The listed benefits of reflection include incorporation and exploration of an evidence base into a clinician's practice; avoidance of routine practice; identification of shortfalls in knowledge; and identification of learning needs by the reflector ( Jasper et al, 2013 ). Nine nearly qualified student paramedics took part in this qualitative study. The findings showed a positive attitude towards reflection among the students. Various barriers to reflection were identified. There appeared to be a lack of reflection and reflective practice in some sections of the paramedic workforce. Analysis of the findings have implications for both paramedic practice and paramedic education. This article is a summarised version of a research piece; therefore not all findings will be discussed.
42
Kirk, Andrew, Kevin Armstrong, Niina Nurkka, and Annette Jinks. "The impact of blame culture on paramedic practice." International Journal of Emergency Services 7, no. 3 (November 12, 2018): 214–27. http://dx.doi.org/10.1108/ijes-10-2017-0052.
Full textAbstract:
Purpose The purpose of this paper is to explore English and Finnish paramedic perceptions of the healthcare blame culture, its relationship to complaints, the use of defensive practice and if this impacts on paramedic practice and clinical care. Design/methodology/approach Participants were recruited from English and Finnish ambulance services that have similar organisational and professional scopes of practice. The aim was to gain insight into the similarities and differences between the countries regarding the existence of a blame culture in paramedic practice. Semi-structured focus groups and interviews involving 20 English and Finnish paramedics were undertaken. Qualitative perceptions concerning the reality of a blame culture in paramedic practice and its impact on professional roles were sought. Findings Three major themes that were identified in the thematic analysis included: blame culture and its influences; the impact of complaints against paramedics; and the use of defensive practice within their roles. These data themes were similar for both groups of participants. The majority of participants thought the healthcare blame culture to be widespread and believed that this was likely to directly influence paramedics’ working practices. Originality/value Whilst the impact of blame culture and complaints on the medical profession has previously been examined, this study makes an important contribution by exploring the factors that impact on paramedics’ lives and their practice, within two European countries. The inappropriate use of social media by some members of the public in both countries was a disturbing issue for many participants and was identified as an area for further research.
43
Jagos, K., I. Drennan, M. McNamara, and J. Limoges. "P112: Strengthening inter-professional collaboration in home-based community paramedic programs." CJEM 22, S1 (May 2020): S105. http://dx.doi.org/10.1017/cem.2020.318.
Full textAbstract:
Introduction: Community paramedic programs are being implemented to leverage existing resources and contribute to a sustainable patient-centered healthcare system. Expanding the role of paramedics into home care requires new collaborative relationships with healthcare providers such as nurses and physicians. Developing effective and productive collaborative relationships will enhance and support the integration of community paramedic programs. Our objective was to describe the barriers and facilitators to effective collaboration between nurses, physicians, and paramedics within home-based community paramedicine. Methods: We conducted semi-structured interviews with nurses, physicians, paramedics, and faculty who teach in paramedic programs. We explored the attitudes, perceptions, barriers, and enablers to collaboration in home-based community paramedic programs. Participants were recruited utilizing the professional networks of the researchers as well as snowball sampling. Recruitment in each group stopped when saturation was achieved. We conducted a thematic analysis of the interviews to generate findings related to our objectives. Results: We interviewed 33 participants with a typical cross-section of age, years of experience, and education. Overall, participants felt that collaboration was important for effective integration of community paramedics into home care and for ensuring a patient-centered approach to care. Currently, collaboration mostly occurs between physicians and paramedics and community paramedicine appears to be a siloed rather than integrated service. Few collaborative relationships exist between paramedics and nurses, despite the fact that nurses are highly involved in home care. We identified several barriers to effective collaboration including lack of understanding of the contributions of the different health providers, and regulatory and funding constraints. Inter-professional education that supports collaboration and facilitates dismantling of professional and service silos can support the effective integration of paramedics into home care. Conclusion: Strengthening networks of collaboration between nurses, physicians, and paramedics can help dismantle silos and enhance inter-professional collaboration to support appropriate integration of paramedics into home care. The willingness and positive attitudes for collaboration are assets that provide an excellent foundation upon which to move forward. Continuing education to support inter-professional collaboration is needed.
44
Smith, J. Chris, and Wesley Burr. "02 Leveraging paramedic data to investigate the effect of COVID-19 on community opioid overdoses." Emergency Medicine Journal 38, no. 9 (August 19, 2021): A1.2—A2. http://dx.doi.org/10.1136/emermed-2021-999.2.
Full textAbstract:
BackgroundOpioid overdoses in Canada have shown dramatic increases over recent years, despite significant investments in harm reduction. Most community monitoring currently relies on emergency department and coroner data. Our team has previously shown that paramedic data can be a useful addition to the current metrics as paramedics regularly interact with opioid overdose patients. This study examines paramedic data to investigate the changes to community opioid overdoses in the era of COVID-19 to better support our strategic partners in their battle against the opioid crisis.MethodsThe electronic ambulance call report database of Peterborough Paramedics (Ontario, Canada) was examined. De-identified records for patients from 2017-2020 with documented problem codes of ‘Opioid Overdose’ were extracted. Patients receiving paramedic naloxone were also included. The data was cleaned and analysed, and incomplete records were removed. Statistical models including chi-squared tests of goodness-of-fit and post hoc pairwise t-tests were applied to the data. Ethics approval for this study was granted by the Trent University’s Research Ethics Board.Results788 opioid overdoses were identified out of 72,737 patients. There were 263 opioid overdoses found in 2020 representing 1.4% patients, a significant increase from 2017-2019 (p value: 0.006). The proportion of patients receiving paramedic naloxone was significantly increased from previous years (p value: 0.005) while bystander naloxone administration was significantly decreased (p value 0.002). Age, gender, and pick-up location types were not significantly different between 2020 and previous years.ConclusionDespite reduced overall call volumes in 2020, paramedics observed an increase in opioid overdoses. The increase in paramedic naloxone administration and decrease in bystander naloxone administration may indicate changes in usage practices of community opioid users or an instability in the drug supply. These factors must be considered in future opioid harm reduction strategies and public health COVID-19 containment measures.
45
Hayes, Catherine, Ian Corrie, and Yitka Graham. "Paramedic emotional labour during COVID-19." Journal of Paramedic Practice 12, no. 8 (August 2, 2020): 319–23. http://dx.doi.org/10.12968/jpar.2020.12.8.319.
Full textAbstract:
Emotional preparedness is required for emergency paramedic practice. Emotional labour underpins the role of paramedics at the frontline of patient care. During the COVID-19 pandemic where patients are at their most vulnerable, it is imperative that paramedics can offer both reassurance to parents and be empowered in the face of the virus. Dealing with COVID-19 has put stress on paramedics, for whom psychological wellbeing is imperative to their capacity to cope in exceptionally challenging circumstances, where death has so frequently characterised the most severe cases of the virus.
46
Eby, D., J. Robson, and M. Columbus. "P038: How frequently is hypoglycemia found in ambulance calls for “seizure”?" CJEM 18, S1 (May 2016): S91. http://dx.doi.org/10.1017/cem.2016.214.
Full textAbstract:
Introduction: Paramedics often attend seizure patients in the pre-hospital setting. Received wisdom is that hypoglycemia is frequently present during a seizure or is a ‘cause’ of seizures. Recent literature disputes this. The purpose of this study was to determine the frequency of hypoglycemia in patients identified as having “seizure” listed as the primary or final problem code in Ambulance Call Reports from a large regional paramedic base hospital program. Methods: Retrospective analysis of a database of ambulance call reports (ACRs) from January 01-December 31, 2014. All 2854 ACRs with paramedic determined primary or final problem codes of “seizure” were identified from a database of all calls performed by 8 municipal paramedic services covering a total urban and rural population of 1.4 million. Municipal paramedic services used iMedic electronic ACRs. A 10% sample generated by a random number table was analyzed. ACRs were manually searched and data extracted onto spreadsheets. Results were described using frequencies and summary statistics. Results: A total of 285 call were analyzed. 207 (72.6%) calls were adults and 78 (27.4%) were paediatric (age <18). Seizures were witnessed by paramedics in 23/285 (8.1%) calls; adults 17/207 (8.2%), paediatric 6/78 (7.7%). A blood sugar was determined in 237/285 (83.2%) of all calls; adults 182/207 (87.9%), paediatric 55/78 (70.5%). In calls were paramedics witnessed a seizure a blood sugar was determined 17/21 (80.9%) of the time; adults 13/17 (76.5%), paediatric 6/6 (100%) Hypoglycemia (BS < 4.0 mm/L) was found in only 1 case - 1/237 (0.4%); adults 0/ 207 (0%), paediatric 1/78 (1.3%). The child was age 1, had a GCS 13, and the blood sugar was 3.9 mm/L. Conclusion: Hypoglycemia was rarely found in patients who had a seizure and were attended to by paramedics in the pre-hospital setting. The routine determination of blood sugars in all patients who have had a seizure prior to paramedic arrival should be reconsidered.
47
Sinclair, J. E., P. Price, M. A. Austin, A. Reed, and E. S. Kwok. "MP02: Paramedic safety culture across Eastern Ontario." CJEM 19, S1 (May 2017): S65. http://dx.doi.org/10.1017/cem.2017.168.
Full textAbstract:
Introduction: Safety culture is defined as the shared beliefs that an organization’s employees hold relative to workplace safety. Perceptions of workplace safety culture within paramedic services have been shown to be associated with patient and provider safety outcomes as well as safe work practices. We sought to characterize paramedics’ perceptions of the organizational safety culture across Eastern Ontario, Canada to provide important benchmarking data to evaluate future quality initiatives. Methods: This was a cross-sectional survey study conducted September 2015-January 2016 in 7 paramedic services across Eastern Ontario. We distributed an abridged version of Patterson’s previously published EMS-SAQ survey, measuring six domains of workplace safety culture, to 1,066 paramedics during continuing medical education sessions. The questions were presented for rating on a 5 point Likert scale (1=strongly agree, 5= strongly disagree) and a response of 1 or 2 was considered a ‘positive perception’ response. We present descriptive statistics and chi-square tests where appropriate. Results: We received responses from 1,041 paramedics (97.6%), with a response rate varying between 88.0% and 100% across the 8 paramedic services. One third (33.6%) were Advanced Care Paramedics (ACPs) and 39.4% of paramedics had more than 10 years’ experience. The percentage of positive responses for each domain were: Safety Climate 31.2% (95% CI 28.4-34.1), Teamwork Climate 29.3% (95% CI 26.6-32.1), Stress Recognition 56.8% (95% CI 53.8-59.8), Perceptions of Management 67.0% (95% CI 64.0-69.8), Working Conditions 42.6% (95% CI 39.6-45.7), Job Satisfaction 41.6% (95% CI 38.6-44.6). Primary care paramedics had more positive perception responses for Job Satisfaction (45% vs 35%, p=0.002), whereas ACPs had more positive perception responses for Stress Recognition (61.5% vs 54.1%, p=0.022). No association was found between gender or years of experience and a positive perception of any safety domain. Conclusion: The results provide valuable workplace safety culture data that will be used to target and evaluate needed quality improvement initiatives while also raising some awareness to paramedics of important factors related to patient and provider safety.
48
Park, Jeong-Mi, and Su-Min Kim. "Comparison of paramedic image and its determinants between paramedic and non-paramedic students." Korean Journal of Emergency Medical Services 19, no. 2 (August 31, 2015): 39–49. http://dx.doi.org/10.14408/kjems.2015.19.2.039.
Full text
49
Jones, Charles, and Bryan Lightowler. "The efficacy of the HEART score in prehospital settings." Journal of Paramedic Practice 14, no. 5 (May 2, 2022): 198–211. http://dx.doi.org/10.12968/jpar.2022.14.5.198.
Full textAbstract:
Background: HEART scores are a well-validated tool used to risk stratify patients with chest pain in the emergency department. Currently, no triage or risk stratification tool is available in the UK prehospital arena. Methods: A comprehensive literature search was carried out to determine the effectiveness of HEART score use by paramedics in the prehospital environment. Findings: Prehospital HEART scores completed by paramedics appear to have a high sensitivity and negative predictive value for detecting major adverse cardiac events. The use of high-sensitivity cardiac troponin assays or a prehospital modified HEART Pathway may allow patients to be triaged based on a single point-of-care (POC) cardiac troponin test. As POC devices improve, this is likely to increase the accuracy of paramedic HEART scores. Additionally, there are some differences between HEART scores calculated by doctors and paramedics. Conclusion: The use of HEART scores prehospitally has the potential to improve patient outcomes. However, issues remain over the accuracy of POC devices and with paramedic interpretation of electrocardiograms and cardiac history-taking. Furthermore, the lack of POC testing in current UK paramedic scopes of practice raises questions over the practicality of introducing HEART scores, which would rely on POC testing.
50
Ross, Linda, and Jessica Bertucci. "Pathway to Paramedicine Program Perspectives – Part 1 Paramedic Students." Australasian Journal of Paramedicine 11, no. 6 (November 4, 2014). http://dx.doi.org/10.33151/ajp.11.6.130.
Full textAbstract:
IntroductionParamedic practice has evolved significantly with a greater emphasis now being placed on paramedics to perform educator type roles to junior paramedics, patients and the wider community. Paramedic training and education should therefore include preparing students for this important role. The Pathway to Paramedicine Program used a peer assisted learning (PAL) model to expose paramedic students to the educator/mentor role. The aim of this study was to evaluate the student paramedic’s perspectives of the Pathway to Paramedicine Program.MethodsFourteen paramedic students enrolled in either Monash University’s Bachelor of Emergency Health (Paramedic) degree or the Bachelor of Nursing/Emergency Health (Paramedic) degree were the subjects of this pilot study. The paramedic students acted as mentors/educators to secondary school students, teaching them theory and practical skills common to paramedic practice during weekly tutorials. The Pathway to Paramedicine Evaluation (PPE) survey was used to determine the participant’s perspectives at the completion of the program.ResultsAll 12 Likert scale questions on the PPE achieve a median score of 4 or higher with four items achieving a maximum median of 5 (strongly agree). A thematic analysis of the free text questions found that the participants enjoyed teaching and this helped to reinforce their own knowledge and skills.ConclusionsThis pilot study showed that the paramedic student’s had an overwhelmingly positive perspective of The Pathway to Paramedic Program and would happily recommend it to others.