Community paramedic roles are expanding internationally, and no review of the literature could be found to guide services in the formation of community paramedicine programmes. For this reason, the aim of this restricted review was to explore and better understand the successes and learnings of community paramedic programmes across five domains being; education requirements, models of delivery, clinical governance and supervision, scope of roles and outcomes. This restricted review was conducted by searching four databases (CENTRAL, ERIC, EMBASE, MEDLINE and Google Scholar) as well as grey literature search from 2001 until 28/12/2021. After screening, 98 articles were included in the narrative synthesis. Most studies were from
The aim of this systematic review and meta‐analysis was to evaluate the outcomes of patients who are not transported to hospital following ambulance attendance. A database search was conducted using PubMed, Medline, Embase, CINAHL and Cochrane Library. Studies were included if they analysed the outcomes of patients who were not transported following ambulance attendance. The primary outcome of this review was subsequent presentation to an ED following a non‐transport decision. Secondary outcome measures included hospital admission, subsequent presentation to alternative service provider (e.g. private physician), and death at follow up. The search yielded 1953 non‐duplicate articles, of which 10 met the inclusion criteria. Three studies specified that the non‐transport decision was emergency medical services (EMS)‐initiated, seven studies did not specify. Meta‐analysis found substantial heterogeneity between estimates (I2 >50%) that was likely because of differences in study design, length of follow up, patient demographic and sample size. Between 5% and 46% (pooled estimate 21%; 95% CI 11–31%) of non‐transport patients subsequently presented to ED. Few (pooled estimate 8%; 95% CI 5–12%) EMS‐initiated non‐transport patients were admitted to hospital compared to the unspecified group (pooled estimate 40%; 95% CI 7–72%). Mortality rates were low across included studies. Studies found varying estimates for the proportion of patients discharged at the scene that subsequently presented to ED. Few patients were admitted to hospital when the non‐transport decision was initiated by EMS, indicating EMS triage is a relatively safe practice. More research is needed to elucidate the context of non‐transport decisions and improve access to alternative pathways.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.