Research

Prehospital administration of calcium in trauma

Background Calcium depletion in haemorrhagic shock is associated with pathophysiology detrimental to survival. Aim The purpose of this systematic literature review was to determine whether paramedic administration of calcium for haemorrhagic shock could reduce trauma morbidity and mortality. Method The MEDLINE and CINAHL databases were searched for publications relevant to hypocalcaemia management in traumatic haemorrhage. Findings Fourteen peer-reviewed articles met the inclusion...

Prevalence, severity and preventability of prehospital patient safety incidents

The provision of safe and effective healthcare is a mainstay for all services and clinicians associated with the delivery of prehospital care; however, little is empirically known about the prevalence and impact of harm caused in the prehospital phase. This commentary critically appraises a recent systematic review which sought to identify the frequency of patient safety incidents and the harm associated with them in prehospital care.

Reaching underserved people during the pandemic

Background: As the COVID-19 crisis evolved, many emergency medical technicians (EMTs) and community paramedics (CPs) were already positioned to engage with both the community and the health system. Aim: This project, based in Indiana, USA, aimed to provide resources for EMTs and CPs to build knowledge and skills necessary to use promising practices related to COVID-19 and provide culturally competent care using telehealth to improve access to care for underserved populations during the...

The efficacy of the HEART score in prehospital settings

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...

Predicting conveyance to the emergency department for older adults who fall

Background: Falls are frequent in older adults and are associated with high mortality, morbidity and immobility. Many patients can be managed in the community, but some will require conveyance to the emergency department (ED). Aims: This study aims to identify predictive characteristics of conveyance to the ED after a fall. Methods: A cross-sectional study between December 2018 and September 2020 involved patients attended by a falls rapid response service. Eligible patients were aged ≥60...

Prognostic value of lactate in out-of-hospital cardiac arrest: a prospective cohort study

Background: The prognostic role of lactate in out-of-hospital cardiac arrest (OHCA) remains unclear. Aims: To explore serum lactate as a predictor of return of spontaneous circulation in patients experiencing OHCA after arrival at hospital. Methods: This 13-month prospective observational cohort study involved patients aged ≥18 years. Serum lactate levels were measured during cardiopulmonary resuscitation before ROSC. Patients were divided into two groups by lactate level: Group 1, low...

Air ambulance outcomes of out-of-hospital cardiac arrest seen in the pandemic

Introduction: COVID-19 was declared a global health pandemic in March 2020, and national lockdowns were imposed in an attempt to limit the spread of the virus. Several studies have reported significant increases in the number of out-of-hospital cardiac arrest (OHCA) attendances coupled with a reduction in return of spontaneous circulation (ROSC). This is the first study to report the characteristics and outcomes from OHCA in a UK air ambulance setting. Methods: A retrospective database review...

Awareness and use of prone position for awake patients with suspected COVID-19

Introduction: Evidence is growing that prone positioning may be a simple, safe, and effective technique to improve oxygenation in awake patients with COVID-19 who are unresponsive to initial therapy. However, there is little evidence about its use in the prehospital environment. This study explores clinician awareness and experiences of this in a large ambulance service in south east England. Methods: An online survey was distributed to 3377 operational ambulance clinicians working for the...

Prehospital point-of-care biomarkers: missing link in acute myocardial infarction?

Coronary heart disease is a leading cause of death worldwide. Paramedics are instrumental in the treatment, triage and transport of patients experiencing acute coronary syndromes and acute myocardial infarction (AMI). Paramedics currently rely on prehospital electrocardiography and patient symptomology to diagnose AMI, which may result in missed diagnoses. Point-of-care biomarkers such as cardiac troponin (cTnT) and copeptin may have the potential to increase the diagnostic capabilities of...

View all Research

Keep up to date with Journal of Paramedic Practice!

Sign up to Journal of Paramedic Practice’s regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month.