AIMS The pattern of interruptions to chest compressions in pre-hospital cardiac arrests in Wellington, New Zealand, was examined prospectively to determine whether the mode of defibrillation chosen by paramedics influenced interruptions, shock success and the return of spontaneous circulation (ROSC). METHODS A prospective observational cohort study of 44 adult cardiac arrests in which 203 sho...

BACKGROUND Evidence in the literature highlights the fact that acute pain in the prehospital setting remains poorly managed. Morphine remains the most commonly used analgesic agent in the South African prehospital emergency care setting. Although guidelines and protocols relating to the dosage and administration of morphine exist, little data are available describing its use by South African pa...

INTRODUCTION The most common reason patients seek medical attention is pain. However, there may be significant delays in initiating prehospital pain therapy. In a 2001 quality improvement (QI) study, we demonstrated improvement in paramedic knowledge, perceptions, and management of pain. This follow-up study examines the impact of this QI program, repeated educational intervention (EI), and eff...

OBJECTIVE Heart disease is the major cause of death in Wales. Myocardial infarction accounts for most fatalities either acutely or as a result of late heart failure and unheralded sudden cardiac death. Prompt relief of new coronary occlusions by thrombolytic agents has been shown to reduce significantly both early mortality and subsequent morbidity from acute myocardial infarction. The prehospi...

The reluctance of physicians to stay in remote and rural hospitals has resulted in a shortage of doctors in these settings, and therefore a decline in the quality of care and an intolerable overload on functioning doctors. However, mature paramedics find it difficult to comply with the demands of ambulance work and look for easier tasks that suit their age. The two problems may have a common so...

This research aimed to gain an understanding of the psychosocial support needs of older patients in the out-of-hospital setting from the perspective of paramedics. Specifically, we investigate if and how paramedics are able to meet the needs of older adults, and the barriers preventing them from achieving this. This study was a cross-sectional study utilizing a sequential design with both quant...

The paper analyzes the ways in which the two paramedics organize their work activities in the courses of interaction with the patient. The paramedic-patient -interaction is generally based on question-answer -sequences where one paramedic asks a question to which the patient answers. The paper examines the organization of paramedics' institutional roles and responsibilities within these particu...

OBJECTIVES Endotracheal intubation success rates in the prehospital setting are variable. Our objective was to describe the challenges encountered and corrective actions taken during the process of endotracheal intubation by paramedics. DESIGN Analysis of prehospital airway management using a prospective registry that was linked to an emergency medical services administrative database. SETT...

BACKGROUND Internationally, continuing professional competence (CPC) is an increasingly important issue for all health professionals. With the imminent introduction of a CPC framework for paramedics and advanced paramedics (APs) in Ireland, this paper aims to identify factors that will inform the implementation of this CPC framework by seeking stakeholder input into the development of a CPC mod...