Research

A mass distribution letter as an early intervention for potential frequent callers

Background: Intensive engagement with frequent callers (FCs) has been shown to be effective at reducing call volumes and producing positive outcomes for service users. Aims: This study aimed to examine the impact of sending a mass distribution letter to potential frequent callers (PFCs) on emergency call volumes. Methods: A standardised letter containing advice and information for newly identified PFCs was introduced in an attempt to signpost service users to more appropriate care providers...

Paramedics’ perspectives of the community paramedic role in Ontario, Canada

Background: Community paramedicine (CP) expands the paramedic role to emergency call prevention, yet little research has examined paramedics’ perspectives of CP. Aims: This study sought to explore paramedics’ views regarding the CP role and training. Methods: A cross-sectional, web-based survey of Ontario paramedics measured perceptions, support and interest in CP. Descriptive and regression analyses were conducted. Findings: Of the 452 participants, 57.5% were male, 43.6% primary care...

Experiences of personal protective equipment and reasons for non-compliance

Background: The COVID-19 pandemic created challenges in prehospital care. Paramedics have been required to adhere to strict protocols regarding infection control and the use of personal protective equipment (PPE). These protocols have evolved as the pandemic progressed. Understanding the experiences of paramedics in using PPE and their reasons behind not adhering to recommended guidelines should improve the limited evidence base and assist healthcare organisations to form tailored PPE guidance,...

To what extent is end-tidal carbon dioxide a predictor of sepsis?

Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. It is a major cause of death worldwide; 245 000 cases are reported in the UK annually with a mortality rate of 20.3%. Rapid diagnosis and rapid treatment of sepsis can significantly reduce mortality but sepsis can be difficult to diagnose. End-tidal carbon dioxide (EtCO2) is the measurement of expired CO2 using capnometry and waveform capnography. For CO2 to be exhaled, it must be...

Prehospital practitioner awareness and experience of CPR-induced consciousness

Background: Cardiopulmonary resuscitation-induced consciousness (CPRIC) is an important but under-researched area. CPRIC in Irish emergency services has never been examined and this study aimed to explore the experiences of prehospital practitioners. Methods: This study includes qualitative and quantitative elements, using an online anonymous survey followed by a confidential, one-to-one, semi-structured interview with emergency medical technicians, paramedics and advanced...

Gamma-hydroxybutyrate (GHB): a review for the prehospital clinician

Background: Gamma-hydroxybutyrate (GHB) is a depressant of the central nervous system with euphoric effects. It is being increasingly used recreationally in the UK, despite associated morbidity and mortality. Because evidence is lacking, health professionals remain unsure as to the optimum management of GHB acute toxicity. Methods: A literature review was undertaken on GHB pharmacology and the emergency management of its acute toxicity. Findings: GHB is inexpensive and readily available...

Diagnostic ability of a computer algorithm to identify prehospital STEMI

Background: Acute myocardial infarction (AMI) accounts for 43% of deaths related to ischaemic heart disease, with ST-segment elevation myocardial infarction (STEMI) accounting for 25%–40% of all AMI presentations. Given the impact of these diseases, there is a strong prehospital focus on early identification, treatment and transport of patients with acute coronary syndrome. The main aim of the STEMI system of care is to reduce the time to reperfusion of the myocardium, thereby improving...

The role of individual factors in the mental health of NHS ambulance personnel

Background: An estimated 27% of ambulance personnel experience general psychological distress. The relationship between work and mental health is complex. Aims: This study aimed to explore whether and to what extent individual factors affect the mental health of ambulance personnel. Methods: Four UK NHS ambulance trusts facilitated recruitment of ambulance personnel (n=160). Well-validated measures were used to collect data on the predictor variables: the Perceived Stress Scale; the...

Troponin testing in primary care: can it improve diagnosis and prevent admission?

Introduction: With the growing demand on emergency departments, expanses in the clinical capabilities of prehospital healthcare facilities have become a hot topic. The use of point-of-care troponin testing (POCTT) has been greatly debated due to the sensitivity limitations of the current testing machines. The current systematic review will collate the current research and attempt to confirm whether troponin testing in primary care can improve diagnostic capabilities and prevent onward admission...

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