A Paramedic Field Supervisor's Situational Awareness in Prehospital Emergency Care

Norri–Sederholm, Teija; Kuusisto, Rauno; Kurola, Jouni; Saranto, Kaija; Paakkonen, Heikki

doi:10.1017/s1049023x14000132

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…The most common reason, according to respondents of this study, was care providers' assessment of the patient's situation. [16] As regards psychosocial reasons as a background for non-conveyance, the findings are consistent with earlier research, which states that the emergency team is sometimes only called "to be on the safe side". In many cases the patient does not require transport to hospital [12,20] or cannot be considered a client of emergency care services.…”

Section: Discussionsupporting

confidence: 88%

“…The finding brings into mind the importance of gaining correct and adequate patient information to support decision-making. [16] Earlier, a doctor's assessment and decision has been described as the reason for non-transportation. [12] It has also been repeatedly confirmed that emergency care providers' work is characterized by hurry and stress.…”

Section: Discussionmentioning

confidence: 99%

“…[16] For some time it has been suggested that care providers should have more to say about whether to convey the patient to hospital or not. [6] A study confirmed that appropriately trained paramedics with extended skills can provide care that is at least as safe as the standard care provided by emergency medical services and emergency departments.…”

Section: Introductionmentioning

confidence: 99%

“…[17] Other studies claim that paramedics cannot always safely decide, which patients to transfer to hospital. [18,19] Still, to be able to perform as well as possible, care providers need to have the right information [16] and focused guidelines to support their decision making. [20] Support and training are needed to increase care providers' confidence, and with appropriate training, it is possible to treat even aged patients at home safely.…”

Section: Introductionmentioning

confidence: 99%

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Non-conveyance of patients: Challenges to decision-making in emergency care

Leikkola¹,

Mikkola²,

Salminen‐Tuomaala

et al. 2016

Clinical Nursing Studies

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Background: It has been suggested that emergency care providers' decision-making competence should be strengthened regarding whether or not to transport the patient. This qualitative study describes challenges related to non-conveyance situations from emergency care providers' perspective. Methods: Data were collected by a questionnaire from emergency care providers of a hospital district in Finland in 2014. Responses to open questions were analyzed using inductive content analysis to examine the difficulty of non-conveyance decisions, reasons for non-conveyance and challenges related to the non-conveyance decision after immediate care. Results: The majority (70%) of care providers did not experienced difficulty in making non-conveyance decisions, although those working in basic emergence care found decision-making slightly more challenging than workers in advanced emergency care. Care providers' reasons for not transporting patients were most commonly connected with their assessment of care needs and the conclusion that no hospital care was required. Other reasons involved treating the patient on site, psychosocial reasons and not seeing the patient as an emergency care client. Difficulty of reaching mutual understanding with patients was considered the greatest challenge. Other challenges included worrying about the patient's coping at home and problems in inter-professional co-operation, related to hurry and the concern that doctors did not always document requests for care instructions. Conclusions: The results suggest that care providers' skills in assessing care needs and making decisions based on assessments are a decisive factor in non-conveyance situations. Reaching a mutual understanding with the patient is the greatest challenge.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Non-conveyance of patients: Challenges to decision-making in emergency care

Leikkola¹,

Mikkola²,

Salminen‐Tuomaala

et al. 2016

Clinical Nursing Studies

View full text Add to dashboard Cite

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“…Bearing in mind that a research should not interfere the often hectic work of Emergency Response Centre operators it would, however, be extremely difficult to monitor real-life situations so closely that adequate research data could be gathered. The method applied in this study had been tested in previous studies with both PFS and emergency medical dispatchers (Norri-Sederholm et al, 2014a, 2014b. The progressive scenarios had turned out to be realistic and responding to the needs of scientific inquiry.…”

Section: Limitationsmentioning

confidence: 99%

Information flow and situational awareness in emergency medical dispatch

Norri–Sederholm

Seppälä

Saranto

et al. 2016

IJNVO

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Provider (PCP) program. They were randomized into either a UAV group or a non UAV group. The study scenario was based on a highway accident involving ten vehicles with seven hazards. Each group was given a 60 minute lecture on UAV technology, and a 30 minute lecture on hazards. Each subject entered the scene after receiving a brief narrative. Having been informed that there were 7 hazards to be identified, the UAV group remained at the UAV ground station while the non UAV group was able to approach the scene. After identifying all hazards, the time to identification and order was recorded. Primary outcome measures were the difference in time to identification, and difference in identification order. Results: The mean time (SD, range) to identify the hazards were 3'68" (1.62, 1'48"-6'48") and 2'43" (0.92, 1'43"-4'38") in UAV and non UAV groups respectively, corresponding to a mean difference of 58" (P = 0.11). A non parametric permutation test showed a significant (P = 0.04) difference in the hazard identification order driven by two hazards, fuel and workplace hazardous material information system placard. Conclusion: This study demonstrated that there is a statistical difference in the identification order of hazards. Interestingly, preliminary results were unable to identify a difference in time to hazard identification. Study/Objective: The study objective is to make the basis of a chemical emergency medical information system. Background: There are many database sets and websites which provide chemical databases in chemical accidents, but they don't have adequate roles for emergency medical support in Korea. Methods: We reviewed the database sets and websites, which provide chemical database and emergency medical records in prehospital transport to hospitals. After an analysis was done, an adequate database set was proposed, and the algorithm for elicitation of chemicals suitable for emergency medical support, accident cases. Results: By four steps of elicitation of chemicals, the number of chemicals of more than 100,000 was decreased to less than 1,000. The standard steps were accident preparedness, toxicity, and circulating amounts. We made an algorithm for the elici-tation of chemicals. Conclusion: When mass exposure by toxic chemical occurs, chemical emergency medical information systems will be helpful for acute identification of chemical and emergency medical response. Study/Objective: To determine the nationwide current status of hospital awareness in emergency and disaster preparedness. Background: Hospital awareness and preparedness is the cornerstone for community health management in emergency and disaster as it plays a critical role in taking care of injured patients. To assess the current system is the first necessary step to improve hospital readiness for emergency and disaster. Methods: A questionnaire was distributed to every provincial, general, and university hospital in Thailand. The data were extracted and reported as number and percentage. Single logistic regression analysis was used to ...

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