Pre-Hospital Advanced Life Support Education – Core Components for Pre-Hospital Professionals

Abstract

<jats:p>IntroductionThere is a broad evidence base supporting advanced life support (ALS) education to health care professionals to be structured, realistic and inclusive of a range of human factors. However, published literature largely focusses on ALS education within institutional settings such as hospitals and associated health care facilities, with typically predictable human and material resources. The aim of this paper is to explore the literature on ALS education and report the results of an international survey undertaken to identify those educational elements which differ in the pre-hospital setting compared to the institutional setting. High quality education in pre-hospital resuscitation is important because it is critical that pre-hospital professionals provide high quality ALS to maximise the likelihood of patient survival.MethodsMEDLINE was searched using MESH terms ‘resuscitation’, ‘advanced life support’ and ‘prehospital’ as core terms. Fifteen articles relating specifically to pre-hospital resuscitation and a further 91 articles on resuscitation education were reviewed. Articles ranged in publication year from 1987 to 2016.An online survey on ALS education was developed and administered and attracted 177 responses from a range of health care professionals nationally and internationally. A total of 83 respondents completed the full survey.ResultsThe literature identifies that best practice ALS education should (a) be taught in the environment in which ALS will be performed, (b) involve team members who are similar to those they will encounter while providing ALS, and (c) use equipment the provider uses in their workplace. Human factors, in particular leadership and communication, are important components of ALS education. However, results of the survey demonstrate that best practice is not well incorporated into pre-hospital ALS education.ConclusionTo improve pre-hospital patient outcomes and maximise the chances of patient survival, ALS education to pre-hospital providers should incorporate the context of their workplace (that is, the environment in which they function), the team members they regularly work with and the equipment they use in the pre-hospital setting. Human factors, in particular leadership, should be considered as part of pre-hospital resuscitation education.</jats:p>

Pre-Hospital Advanced Life Support Resuscitation – a Curriculum for Pre-Hospital Education

“…This finding correlates with the literature, which suggests that education should reflect, as closely as possible, the environment in which course participants are going to be operating (3,8). Following best practice as identified in the literature, the results from this research suggest that a pre-hospital ALS course should have a face-to-face element included (1,6,7). A mixed approach would allow for pre-reading theory and lectures to be completed online, with the face-toface component then concentrating on skills and scenarios.…”

“…A literature review identified the important components in resuscitation education as: the mode of delivery; assessment; simulation and equipment; human factors; and workplace implementation. Resuscitation education was most effective when conducted with a face-to-face component (1,6,7). Teaching in a similar environment to participants' workplaces, promotes congruence between the education and work environment (3,8).…”

“…This paper proposes a curriculum for pre-hospital advanced life support (ALS) education. Previous research (1) found that the pre-hospital environment involves the unique challenges of unpredictable environment and resources, with limited space, suboptimal lighting and unpredictable bystander behaviour (2). Pre-hospital providers may also have to move and perform resuscitation procedures on a narrow stretcher and/or in a moving vehicle.…”

Pre-Hospital Advanced Life Support Resuscitation Training: A Pilot of An Evidence-Based Curriculum

“…The aim of this research was to pilot a pre-hospital (ie. resource-limited) ALS resuscitation course based on a curriculum developed from previous research (1,6) and determine whether it met the needs of participants in relation to their regular working environment. Overall, the course appeared to have met participant needs, with all participants indicating the course learning objectives were fully or partially met.…”

“…A literature review (6) identified the important components in resuscitation education as being: mode of delivery; assessment; simulation and equipment; human factors; and workplace implementation. Following best practice in the literature, the pilot pre-hospital ALS resuscitation course was delivered with a face-to-face component (1,7,8). Teaching was conducted in an environment similar to participants' workplaces to promote congruence between the education and the work environment (3,9).…”