The challenges of pre-hospital paediatric trauma care

Reavley, Paul

doi:10.12968/jpar.2014.6.1.18

Cited by 3 publications

(2 citation statements)

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“…As the subject of 4.5-13.0% of total call-outs, paediatric patients represent a reasonable minority of paramedics' workload (1)(2)(3)(4)(5). Previous research suggests that cases involving children can evoke anxiety and discomfort, and that resultant feelings of low confidence and self-efficacy can cause a reluctance to initiate timely appropriate treatment, possibly contributing to patient morbidity and mortality (21,30,31). However, it is unknown to what extent these apprehensionproducing perceptions are held by paramedics and what educational strategies can improve them.…”

Section: Discussionmentioning

confidence: 99%

“…Some paramedics may prefer to quickly transport the patient to a well-resourced emergency department ('scoop and run') in preference to stabilising the child at the scene (12). It is possible that such situations contribute adversely to patient safety (12,21) and are at odds with the developing professional identity of paramedics as advanced clinical decision-makers (21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

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Improving Paramedic Confidence with Paediatric Patients: A Scoping Review

Fowler

Beovich

Williams

2018

Australasian Journal of Paramedicine

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IntroductionPaediatric patients comprise a reasonable minority of paramedic workload, but cases involving children often evoke anxiety and discomfort. Subsequent feelings of low confidence and self-efficacy have been linked with a reluctance to initiate treatment and possibly, poorer care. It is unknown to what extent these apprehension-producing perceptions are held by paramedics and what educational strategies can improve them. This study aims to fill this gap by reporting on a scoping review that examined and mapped the effectiveness of educational interventions on improving paramedic perceptions of caring for paediatric patients.MethodsArksey and O’Malley’s scoping methodology was used. CINAHL, AMED, EMBASE, MEDLINE and PsychINFO databases were searched, alongside several networks and grey literature services. The search strategy was validated by a subject research-librarian. Two reviewers independently reviewed retrieved articles against inclusion and exclusion criteria determined in advance.ResultsSeventeen articles were included in the review, comprising six conference abstracts, one letter to the editor and 10 journal articles. These articles were categorised into three themes: identifying educational needs and preferences, novel education programs and evaluating education delivery methods.ConclusionParamedics feel uncomfortable treating paediatric patients and desire more paediatric training, particularly simulation and exposure to children. There is insufficient evidence to demonstrate superior effectiveness of any particular training program. While the most effective education delivery method is unclear, it seems web-based learning can be as effective as traditional teaching. The efficacy of existing pre-established paediatric training programs needs to be investigated, alongside paediatric education in the initial training curriculum. Further research, particularly from outside the United States of America, is needed to identify and develop the most effective educational intervention to improve paramedic confidence with paediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving Paramedic Confidence with Paediatric Patients: A Scoping Review

Fowler

Beovich

Williams

2018

Australasian Journal of Paramedicine

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Looking back to inform the future: a review of published paramedicine research

Cavanagh

Blanchard

Weiss

et al. 2023

BMC Health Serv Res

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Objective Paramedicine has evolved in ways that may outpace the science informing these changes. Examining the scholarly pursuits of paramedicine may provide insights into the historical academic focus, which may inform future endeavors and evolution of paramedicine. The objective of this study was to explore the existing discourse in paramedicine research to reflect on the academic pursuits of this community. Methods We searched Medline, Embase, CINAHL, Google Scholar and Web of Science from January, 2006 to April, 2019. We further refined the yield using a ranking formula that prioritized journals most relevant to paramedicine, then sampled randomly in two-year clusters for full text review. We extracted literature type, study topic and context, then used elements of qualitative content, thematic, and discourse analysis to further describe the sample. Results The initial search yielded 99,124 citations, leaving 54,638 after removing duplicates and 7084 relevant articles from nine journals after ranking. Subsequently, 2058 articles were included for topic categorization, and 241 papers were included for full text analysis after random sampling. Overall, this literature reveals: 1) a relatively narrow topic focus, given the majority of research has concentrated on general operational activities and specific clinical conditions and interventions (e.g., resuscitation, airway management, etc.); 2) a limited methodological (and possibly philosophical) focus, given that most were observational studies (e.g., cohort, case control, and case series) or editorial/commentary; 3) a variety of observed trajectories of academic attention, indicating where the evolution of paramedicine is evident, areas where scope of practice is uncertain, and areas that aim to improve skills historically considered core to paramedic clinical practice. Conclusions Included articles suggest a relatively narrow topic focus, a limited methodological focus, and observed trajectories of academic attention indicating where research pursuits and priorities are shifting. We have highlighted that the academic focus may require an alignment with aspirational and direction setting documents aimed at developing paramedicine. This review may be a snapshot of scholarly activity that reflects a young medically directed profession and systems focusing on a few high acuity conditions, with aspirations of professional autonomy contributing to the health and social well-being of communities.

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A critical appraisal of the pre-hospital management of cervical spine injury in children and young people

Francis

2015

Journal of Paramedic Practice

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Paediatric cervical spine injury (CSI) has been outlined in current literature as a research priority, where it has been included in the top 10 clinical research priorities by the Pediatric Emergency Care Applied Research Network. This article therefore aims to review the evidence base underpinning UK paramedic practice when managing children and young people at risk of CSI. In this article, particular focus shall be given to clinical practice challenges while exploring the risk over benefit debate of spinal immobilisation. Throughout this article, considerations for future research and of adopted future practice shall also be made.

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The challenges of pre-hospital paediatric trauma care

Cited by 3 publications

References 1 publication

Improving Paramedic Confidence with Paediatric Patients: A Scoping Review

Improving Paramedic Confidence with Paediatric Patients: A Scoping Review

Looking back to inform the future: a review of published paramedicine research

A critical appraisal of the pre-hospital management of cervical spine injury in children and young people

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