Paramedics’ perceptions of Their Role in Palliative Care: Analysis of Focus Group Transcripts

Abstract

Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at the end of life. However, paramedics may not be well prepared to offer palliative care, as practice guidelines and education tend to focus on the management of acute medical emergencies and major trauma. Emergency medical services that employ paramedics rarely have practice guidelines or protocols that deal specifically with palliative care.

Breaking down the silos: Collaboration delivering an efficient and effective response to palliative care emergencies

“…15 In the current climate, where both the community and the hospital system promote home death, paramedics are being called upon to provide emergency backup interventions for patients dying at home. 1 It is often a crisis of confidence from a much needed family caregiver which results in an emergency admission to hospital. 15 Butler et al 16 identified the following reasons that contribute to unplanned hospitalization:…”

“…This will require that palliative care is included as core education for paramedics supported by ongoing training with SPCS providers as well as practice guidelines. 1 Methodology A working group including members from each of the SPCS in Adelaide, SAAS, The Metropolitan Referral Unit, The Royal District Nursing Service, and academic support from Flinders University was established to identify the service provision gaps and to work through all the issues that an alliance with an emergency services provider may cause.…”

“…This stance was taken because the patient may be subjected to resuscitation attempts or possible transport to an emergency department. 1 If death results in the presence of emergency ambulance paramedics then the police will be notified, which exposes family members to unnecessary distress associated with an anticipated and expected death.…”

Paramedics’ Perceptions and Educational Needs with Respect to Palliative Care

“…Increasingly, palliative care is being recognised as an important skill for emergency care providers more broadly (2)(3)(4)(5)(6), and the perspectives of Australian emergency department (ED) staff in providing palliative care have recently been explored (7)(8). Research focused on pre-hospital emergency care providers is limited and mostly deals with end-of-life issues (9)(10)(11) including moral and legal issues related to withholding resuscitation (12)(13) and advance or present directives (14)(15). One study, using a focus group methodology, explored Australian paramedics' knowledge and attitudes related to the care of patients requiring palliative care (15).…”

“…Research focused on pre-hospital emergency care providers is limited and mostly deals with end-of-life issues (9)(10)(11) including moral and legal issues related to withholding resuscitation (12)(13) and advance or present directives (14)(15). One study, using a focus group methodology, explored Australian paramedics' knowledge and attitudes related to the care of patients requiring palliative care (15). This report noted that paramedics lacked practice guidelines for palliative care, education in palliative care, and awareness of available palliative care and community support services.…”