The utilization of mixed methods in prehospital research is relatively new. Its use may enhance research findings, but it is not without its challenges. This study used online databases to systemically search for literature relating to the application of mixed methods in prehospital research, in order to understand the place of mixed methods research in the prehospital setting. The prehospital field appears to be embracing mixed methods as an approach to research due to its ability to address health care questions in complex, diverse environments. However, supplemental literature in this area is limited, with mixed methods expertise being found in other health science areas. Researchers should endeavor to continue to contribute to this area through high-quality, rigorous mixed methods studies.Keywords prehospital, paramedic, mixed methods research, mixed methods, prehospital research Prehospital care takes place in the dynamic, out-of-hospital environment. It is provided within communities by trained health care professionals for ''analytic, resuscitative, stabilizing or preventative purposes'' before and during transportation to a medical facility (Loyola Emergency Medical Services System Policy and Procedure Manual, 2009). Prehospital care has an incredibly wide scope-paramedics manage injuries and illnesses ranging from the very minor to the immediately life-threatening, in a range of environments and conditions, with time and resource constraints. Likewise, parameters for prehospital research are extraordinarily wide, with researchers investigating topics from clinical, systems-related, and educational standpoints.The utilization of mixed methods in prehospital research is relatively new for two reasons. First, prehospital research is embryonic and evolving. Second, much of the prehospital research

Objective A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expanded-scope paramedics, health promotion and the role of paramedics as key members of local communities. There were no studies specifically related to the paramedic role in health education, although many papers referred to health education as one of many roles paramedics engage in today. Conclusion This review highlights a broadening of paramedicine’s traditional scope of practice, and an indication of how vital paramedics could be to local communities, particularly in rural and remote areas. An expanded role may help address health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers. What is known about the topic? A broadening of paramedicine’s traditional scope of practice has been linked to improvements in health workforce sustainability problems in areas where health care provision is challenged by geographical constraints and low workforce numbers, such as rural and remote Australia. Health education, as well as health promotion, primary health care and chronic disease management, have been proposed as potential activities that paramedics could be well placed to participate in, contributing to the health and well-being of local communities. What does this paper add? This paper identifies and synthesises literature focusing on paramedic-initiated health education in the Australian context, assessing the current health education role of paramedics in metropolitan, rural and remote areas. It provides an understanding of different geographical areas that may benefit from expanded-scope prehospital practice, indicating that the involvement of paramedics in health education in Australia is significantly determined by their geographical place of work, reflecting the influence of the availability of healthcare resources on individual communities. What are the implications for practitioners? Today’s paramedics fill broader roles than those encompassed within traditional models of prehospital care. Rural and remote communities facing increasing difficulty in obtaining health service provision appear to benefit strongly from the presence of expanded-scope paramedics trained in health promotion, primary injury prevention, chronic disease management and health education: this should be a consideration for medical and allied health practitioners in these areas. Australian paramedics are uniquely placed to ‘fill the gaps’ left by shortages of healthcare professionals in rural and remote areas of the country.

Objective To describe the demographic profile and clinical case mix of older adults following calls for an emergency ambulance in rural Victoria, Australia. Methods Retrospective cohort study using ambulance electronic patient care records from rural‐dwelling older adults (≥65 years old) who requested emergency ambulance attendance during 2017. Results A total of 84 785 older adults requested emergency ambulance attendance, representing a rate of 278 per 1000 population aged ≥65 years. More than 10% of calls were to residential aged care homes. Medical complaints and trauma accounted for 69% and 18% of attendances, respectively. The predominant cause of trauma was ground‐level falls. Common reasons for call‐outs were for pain (17.5%), respiratory problems (9.7%) and cardiovascular problems (8.5%). Increased demand was associated with increasing age and winter months. Conclusions Older adults from rural Victoria have high rates of emergency ambulance attendance and transportation to an emergency department, particularly with increasing age.

Background: In rural and regional areas, older Australians have poorer health outcomes and higher rates of potentially preventable hospital admissions than their metropolitan counterparts. Paramedics may be uniquely placed to improve health outcomes of rural-dwelling older adults through involvement in primary and preventive healthcare, health promotion and health education. However, the feasibility and acceptability of this remains unexplored. Aim: To investigate the utility, feasibility and acceptability of paramedic involvement in health education initiatives aimed at rural-dwelling older people. Methods: Semi-structured telephone interviews were conducted with key stakeholders between July and September 2021. Interviews were transcribed verbatim and reflexive thematic analysis was undertaken. Findings: Participants (older people and their carers, n = 3; health service representatives, n = 4; and ambulance service representatives, n = 3) linked acceptability to the position of trust and visibility paramedics held within the community. The coverage provided by ambulance services in rural and regional areas, and the enhanced skills and collaborative relationships that rural paramedics develop, were seen as enabling factors to expanded roles. Conclusion: Key stakeholders’ perspectives on the role of paramedics in health education for rural-dwelling older people highlighted the trust placed in paramedics. Meeting identified needs without competing with established health initiatives was seen as important with respect to paramedic engagement in broader primary health care opportunities.