Research challenges in prehospital care: the need for a simulation-based prehospital research laboratory

Abstract

There is a need for improved research in the field of prehospital care. At the same time, there are many barriers in prehospital research due to the complex context, posing unique challenges for research, development, and evaluation. The present paper argues for the potential of simulation for prehospital research, e.g., through the development of an advanced simulation-based prehospital research laboratory. However, the prehospital context is different from other healthcare areas, which implies special requirements for the design of this type of laboratory, in terms of simulation width (including the entire prehospital work process) and depth (level of scenario detail). A set of features pertaining to simulation width, scenario depth, equipment, and personnel and competence are proposed. Close tailoring between these features and the prehospital research problems and context presents great potential to improve and further prehospital research.

Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis

“…We felt that this was necessary to capture a wider range of data due to a lack of real-world prehospital studies, reflecting the distinct challenges involved with research in this setting. A possible solution to this lies with high-quality simulation, perhaps including dedicated advanced prehospital simulation laboratories [ 30 ]. By developing high-quality simulation, we can overcome the obstacles of research in the prehospital context (such as lack of control), while still being able to study realistic prehospital scenarios complete with serious game-inspired techniques and methods [ 30 ].…”

“…A possible solution to this lies with high-quality simulation, perhaps including dedicated advanced prehospital simulation laboratories [ 30 ]. By developing high-quality simulation, we can overcome the obstacles of research in the prehospital context (such as lack of control), while still being able to study realistic prehospital scenarios complete with serious game-inspired techniques and methods [ 30 ]. This would facilitate the generation of much needed prehospital-oriented randomised controlled trials (RCTs) that can be systematically reviewed to inform guidelines.…”

“…Many of the studies ran with admittedly small samples while one study satisfied just 57% of our quality assessment criteria [ 23 ]. This stresses the need for greater quality control amongst prehospital studies, reinstating the importance of high-quality simulation to overcome the inherent lack of controls in a real-world prehospital setting [ 30 ].…”

Randomised controlled trials in pre-hospital trauma: a systematic mapping review

“…RCTs are a reliable way of assessing the effectiveness (both clinical and cost) of different healthcare interventions but are rare in pre-hospital trauma where studies are often based on registry data using prospective before-and-after designs [ 8 ]. This is partly because there are a number of significant logistical and methodological challenges to conducting RCTs in a pre-hospital trauma setting [ 10 ]. The major difficulties in conducting RCTs in pre-hospital trauma lie in various aspects of trial design and conduct.…”

Pre-hospital Care to Trauma Patients in Addis Ababa, Ethiopia: Hospital-based Cross-sectional Study

“…In low and middle-income countries without formal emergency care system around 80% of deaths in severe trauma occurred in pre-hospital setting( 5 , 6 ). In Ethiopia in the past 10 years, the Federal Ministry of Health has introduced an effort to improve the Emergency Medical Service (EMS) systems.…”