H Haran, Ajay Bhalla, Gillian Cluckie, Jonathan Birns
Journal of Paramedic Practice, Vol. 8, Iss. 10, 17 Oct 2016, pp 494 - 498

Background: The best outcomes for acute stroke treatment occur through
rapid recognition and transfer of patients to hospitals with a hyperacute stroke
unit (HASU). Pre-hospital ambulance paramedics are crucial to this process as
first responders, but they have limited feedback on subsequent patient care and
progress to improve their learning.

Methods: A dedicated stroke training course for paramedics was developed
on a HASU that involved a standardised introductory educational briefing
and subsequent participation in clinical activities with multidisciplinary HASU
staff. On completion of the course, attendees completed a standardised semistructured
questionnaire about their learning and experience. All text was
thematically analysed and themes were developed by iteratively recoding and
regrouping the data.

Results: 30 paramedics attended the training course over a three-month period.
All candidates reported that the course was useful to their learning and training
with 'real-world' transferability; 93% stated that they benefited from observing
clinicians performing assessments on patients and 73% commented that they
gained a better understanding of care pathways and treatment. These two
themes encompassed 48% of 160 free-text responses with the other responses
being grouped into four further themes (improved patient/family communication,
increased awareness of subtle signs of stroke, localisation of intracranial
pathology, and improved 'handover').

Discussion: This single centre experience of HASU training for paramedics
demonstrated a number of key educational themes embedded within the stroke
care pathway. This process may be a useful additional educational resource to
develop further paramedic training in the hyperacute arena.

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