Paramedic Pathfinder: is it really better than current practice?

The recent journal article on Paramedic Pathfinder (Newton et al, 2013) was clearly of great interest to a lot of paramedics— here was a new tool that was being proposed to support paramedics in non-conveyance decisions and to help them divert patients away from the emergency department. However, on closer inspection of the article, and with some critical examination, it becomes apparent that this is not necessarily the step forward that the article claims it to be, and instead is more an indication that there needs to be more rigorous research before a change in current methods can be recommended.

The article justifies the work based on the premise that paramedics and emergency medical technicians are unable to consistently identify those patients who would benefit from non-emergency department (ED) care, and provides a number of references to evidence this. On closer examination of the references, a number are based on American Emergency Medical Services (EMS) provision and there is no justification or evidence that this could be transferred to UK EMS provision given the significant variation between the two systems.