Ambulance Research Repository (AMBER)
Not a member yet
2042 research outputs found
Sort by
Factors that influence paramedic decision-making about resuscitation for treatment of out of hospital cardiac arrest: results of a discrete choice experiment in National Health Service ambulance trusts in England and Wales
No full textComing to a head: auditing clinician adherence to updated English head injury guidance in remote telephone assessment of ambulance service cases
Full text linkKnowledge and barriers of out of hospital cardiac arrest bystander intervention and public access automated external defibrillator use in the Northeast of England: a cross sectional survey study
No full textExploring barriers and facilitators to paramedic engagement in prehospital research
No full textBackground Paramedic engagement is crucial for the success of prehospital research studies. The Head injury evaluatiOn and aMbulancE Diagnosis (HOME) study aims to examine the feasibility of a diagnostic-test accuracy study to assess using the Canadian CT Head Rule in the prehospital setting to improve prehospital triage. However, significant recruitment challenges led to undertaking this qualitative study, aiming to identify barriers and facilitators to paramedic research engagement. Methods A qualitative study was conducted using semi-structured interviews with 13 paramedics with varying experience, both participants and non-participants in the HOME study, to understand their perspectives. Interviews were recorded, transcribed, and analysed using an accepted thematic analysis approach, with data saturation guiding sample size. Results Four themes were identified. The first, Paramedic Perspectives on the HOME study, highlighted potential benefits for practice and patient care and identified recruitment challenges, including the unpredictable nature of paramedic work, geographical restrictions to recruitment, and poor awareness among hospital staff. The second, Personal and Professional Constraints Impacting Engagement, identified barriers such as time constraints due to demanding work schedules, burnout from high-intensity work, and mixed attitudes toward clinical studies, influenced by factors such as generational differences and past research experiences. The third, Considerations for Research Engagement Among Paramedics, explored factors influencing paramedics’ decisions to participate in research, including personal interest in the study topic, its relevance to their practice, flexibility in engagement, and ethical concerns about patient care. The fourth, Strategies for Enhancing Paramedic Research Engagement, suggested offering incentives for participation, enhancing interaction and recognition, and improving communication and organisational support. Conclusion With unpredictable workloads, a complex prehospital environment and multiple demands on their time, paramedics face substantial barriers to research engagement. This can be mitigated by remunerating and rewarding participation, adopting flexible approaches to training and research design and optimising communication and organisational support. https://emj.bmj.com/content/41/Suppl_3/A4.2 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
Resuscitation with pre-hospital blood products in adults with trauma-related haemorrhagic shock: the RePHILL RCT
No full textReporting standard for describing first responder systems, smartphone alerting systems, and AED networks
No full textExperiences of homeless individuals using ambulance services: a narrative review
No full textBackground: Homeless individuals are vulnerable and have a higher burden of illness. Barriers to care exist and experiences can be negative, contributing to increased morbidity and mortality. The experiences of homeless individuals accessing healthcare through ambulance services is underexplored. Aims: The study aims to describe why homeless individuals access healthcare through ambulance services and identify lived experiences. Methods: A narrative literature review was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, with Critical Appraisal Skills Programme tools used to assess quality before thematic synthesis. Results: Twenty three studies were included. Six themes were identified including frequency of ambulance use and clinical characteristics, why healthcare is accessed through ambulance services and the experiences of homeless individuals and paramedics. Conclusions: Evidence relating to homeless individuals accessing healthcare through ambulance services is limited. However, it is clear this group uses these services more often than non homeless individuals, likely because of their higher chronic illness burden. Services should be developed to meet the needs of homeless individuals and to help ensure demand on ambulance services is manageable and affordable. Abstract published with permission
A review of end of life medication administration by ambulance clinicians
No full textAbstract Introduction Historically, paramedics have focused on life-saving and curative Care. Today a growing body of evidence suggests many patients seek support from the ambulance service for Palliative and end of life (EOL)care. This has resulted in ambulance services globally embracing new paradigms of care, including Palliative care. Scottish Ambulance Service (SAS) have partnered with Macmillan to form an EOL care team to drive forward education and pathways for EOL patients, because in Scotland around 95% of people in the last year of life contact unscheduled care services. One of the main requirements of theses contacts is symptom relief. This project looks at the use of JIC and other EOL medication administrations by SAS clinicians. Aims To monitor and report on EOL medication use by SAS clinicians and the usage both prior to and during the Macmillan project to identify the efficacy of education and impact upon practice. Method By retrospectively reviewing the patient report forms the team were able to audit each administration of EOL medications. Determining; If the medication administered was the patient‘s own or SAS stock, The type of medication administered, The impact the medication had for the patient If the patient was conveyed to hospital. Results The results showed, since the implementation of the Macmillan project; The use of EOL medication has increased. The range of medications given by clinicians is broader. The median administration has increase from 6 to 12 Conclusion We believe the introduction of the Macmillan team and the education they have been delivering to clinicians across the country is supporting the increase in EOL medication administrations within SAS. Impact Improved patient care at the EOL, quicker symptom relief, supporting patients at the right time with the right care, in the right place. References Collier A, et al. “‘The palliative care ambulance’: A qualitative study of patient and caregiver perspectives of an ambulance service.” Palliative Medicine 2023;37(6):875–883. Murphy-Jones G, et al. “Infusing the palliative into paramedicine: Inter-professional collaboration to improve the end of life care response of UK ambulance services.” Progress in Palliative Care 2021;29(2):66–71. Juhrmann ML, et al. “Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis.” Palliative Medicine 2022;36(3):405–421. Mason B, et al. “Integrating lived experiences of out-of-hours health services for people with palliative and end-of-life care needs with national datasets for people dying in Scotland in 2016: A mixed methods, multi-stage design.” Palliative Medicine 2022;36(3):478–488. https://spcare.bmj.com/content/14/Suppl_1/A17.2 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0
