Background: Clinical placements are of major importance in students’ learning processes through creating supportive environments and fostering independence into paramedic professional roles. The study aimed to explore whether clinical experiences in out-of-hospital emergency services affected students’ learning outcomes and satisfaction. Methods: A retrospective study was carried out using preceptors’ evaluations (n=160) and students’ feedback forms (n=21). Descriptive and non-parametric inferential statistics were used to analyse quantitative items, and open-ended questions were analysed using content analysis. Results: Findings showed that more than 70% of students were satisfied with the quality of preceptors and the fieldwork atmosphere. Preceptors reported that students’ clinical skills across all categories improved significantly in the last two weeks of training. Qualitative data indicated that students displayed appropriate behaviour and professional socialisation and were keen to learn, and demonstrated competence in paramedicskills. Conclusion: A supportive atmosphere and positive student–preceptor relationships are key attributes for clinical placements if students are to accomplish learning outcomes in out-ofhospital environments.

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IntroductionParamedics are commonly called to complaints of nausea and vomiting with the treatment of these conditions being either antiemetics or palliative measures.  Historically, there have been several antiemetics available to paramedics across Australia and New Zealand with their use varied dependent on each region of practice. The objective of this research was to create a snapshot in time and determine which antiemetics have been used by paramedics, their preferences of use, and their beliefs regarding each antiemetic.MethodsUsing a cross-sectional and online survey, paramedics from across Australia and New Zealand were invited to answer questions regarding their demographics, antiemetics used in practice and then preferences regarding these antiemetics. A 5-point Likert scale and free text qualitative answers were also used to identify particular views and beliefs on the efficacy of the varying antiemetics.Results476 paramedics participated in the study. The participants were predominantly male n=344 (72.3%).  Ondansetron was found to be the most preferred antiemetic for general use in nausea and vomiting n = 378 (82%) with the second line choice being metoclopramide n = 62 (13.4%).  Exceptions to this were for prochlorperazine, which showed a high preference for nausea related to migraine n=179 (56.2%) or vertigo or motion sickness n=243 (42%).ConclusionPreferences and decision making for choosing ondansetron over other antiemetics were primarily its efficacy, minimal side effects and availability.  An exception to ondansetron’s preferred usage was prochlorperazine, which was the preferred medication for cases involving nausea with motion sickness or vertigo.  Historically, metoclopramide has been the most common antiemetic in paramedic practice but is not generally preferred as first line due to its contraindications, perceived lower efficacy over other antiemetics and risk of side effects.

High-rise buildings present unique challenges to providing high-quality CPR. We investigated the effect of using a mechanical compressor and supraglottic airway on flow time and CPR quality in simulated cardiac arrests occurring within a high-rise building. Twelve teams of EMS providers performed CPR according to 4 scenarios: manual compression and ventilation through bag-valve-mask (MAB) or supraglottic airway (MAS); mechanical compression and ventilation through bag-valve-mask (MEB) or supraglottic airway (MES). Chest compression indices did not differ significantly among the groups. The mechanical compression groups had a higher flow time fraction from exiting the elevator until the manikin was loaded into the ambulance than the manual compression groups. The supraglottic airway groups had higher flow time fractions from entering the elevator until the end of the scenario than the bag-valve-mask groups. The total flow time fraction was lowest in the MAB group and was highest in the MEB group (P < 0.001). In simulated cardiac arrest in a high-rise building, the use of a supraglottic airway maintained flow time at a level similar to that observed with the use of a mechanical compressor. Moreover, the use of a mechanical compressor and a supraglottic airway increased the flow time most effectively.

Introduction Mental health presentations are a rapidly growing proportion of cases seen by paramedics who are often at the frontline of care delivery. How paramedics perceive persons with mental illness is vital as their experiences in providing care can significantly impact decision-making. This article aims to investigate these paramedics' experiences and how these influence patient care. Methods This qualitative research study uses a narrative design where the researchers conducted two focus groups with operational paramedics (six paramedics), and the data recorded and transcribed. The team closely examined the data using thematic analysis to identify, analyse, and interpret patterns of meaning within transcribed data. After thematic analysis, a model for future practice was generated, which pictorially demonstrates the overlap of the common themes. Results Five themes ultimately were identified that profoundly appeared to be important to the paramedics within the focus groups. Paramedics have varying experiences when caring for people with mental illness. They are empathetic towards the circumstances of the person with mental illness. They perceive that the stigmatisation of persons with mental illness occurs in some cases. Paramedics are also affected in their clinical decision-making by the training and education they have received and the profession's cultural influences. Conclusion The stigmatisation of people with mental illness is apparent in paramedic practice. Despite mental illness being a common presenting problem, paramedics feel underprepared and have difficulty in treating these people. The patients' behaviour can often be reflected in the conduct of paramedics. The impact of burnout due to high exposure to people with mental illness, especially in metropolitan areas, may lead to decreased levels of empathy and compassion.