Implementation of new guidelines in the prehospital services: a nationwide survey of Norway

Abstract

Background A debate regarding the potential harmful effects of rigid neck collar and backboard usage among prehospital and hospital care providers in Norway provoked the development of an evidence-based guideline. “The Norwegian guideline for the prehospital management of adult trauma patients with potential spinal injury” was developed with rigorous scientific methods and published in 2016. An e-learning course was developed in parallel. The aim of this study is to explore whether emergency medical services personnel in Norway have implemented the guideline, and to what extent the e-learning course was applied during the implementation process. Method An electronic survey was distributed individually to registered prehospital personnel in Norway 18 months after publication of the guideline. Results In all, 938 of 5500 (17%) EMS personnel responded to the survey. More than one-half confirmed knowledge of the guideline; among these, 56% claimed that the guideline was implemented in the service they work. Not having responded to trauma cases in real life was the main reason for not having executed the guideline. The e-learning course had been completed by 18% of respondents. Conclusion Although the guideline has not been authorized or made compulsory by national authorities, one-half of respondents with knowledge of the guideline reported it as implemented. E-learning did not seem to have affected the implementation. The guideline was developed based on perceived needs among care providers, and this probably facilitated implementation of the guideline. Electronic supplementary material The online version of this article (10.1186/s13049-019-0660-0) contains supplementary material, which is available to authorized users.

Studio osservazionale in merito alla validità della Canadian C-Spine Rule in ambito extra ospedaliero

“…Per l'utilizzo del materasso a depressione è stata espressa una raccomandazione debole. L'immobilizzazione spinale in sé non può essere considerata una procedura priva di rischi, la stessa immobilizzazione spinale è associata a rischi documentati e disagio piuttosto estremo [16] . In molti casi sono stati riportati episodi che hanno determinato una grave morbilità e persino la mortalità, secondaria all'immobilizzazione stessa.…”

Paramedic attitudes towards prehospital spinal care: a cross-sectional survey

“…Few studies have examined how emergency medical services (EMS) personnel have responded to these changes. A recent survey from Norway evaluated the use of a new national prehospital spinal treatment guideline, but was focused on implementation, not attitudes towards practice [ 16 ]. Other available research shows that emergency medical technicians (EMTs) in the United States believed that the prior practice of spinal immobilization (SI) was generally over-used, and that those with advanced life support (ALS) qualifications in particular viewed it as often unnecessary or not optimal in certain cases [ 1 , 17 , 18 ].…”