Emergency medical services and palliative care: protocol for a scoping review

Gage, Caleb Hanson; Stander, Charnelle; Gwyther, Liz; Stassen, Willem

doi:10.1136/bmjopen-2022-062054

Cited by 4 publications

(4 citation statements)

References 26 publications

(69 reference statements)

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“…A scoping review of EMS and palliative care literature was performed, the protocol for which has been published previously,17 detailing the methodological framework of Arksey and O’Malley used for this review 18. The steps of this employed framework were (1) identifying the research question, (2) identifying relevant studies, (3) selecting eligible studies, (4) charting data and (5) collating, summarising and reporting results 18.…”

Section: Methodsmentioning

confidence: 99%

Emergency medical services and palliative care: a scoping review

et al. 2023

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ObjectivesThe aim of this study was to map existing emergency medical services (EMS) and palliative care literature by answering the question, what literature exists concerning EMS and palliative care? The sub-questions regarding this literature were, (1) what types of literature exist?, (2) what are the key findings? and (3) what knowledge gaps are present?DesignA scoping review of literature was performed with an a priori search strategy.Data sourcesMEDLINE via Pubmed, Web of Science, CINAHL, Embase via Scopus, PsycINFO, the University of Cape Town Thesis Repository and Google Scholar were searched.Eligibility criteria for selecting studiesEmpirical, English studies involving human populations published between 1 January 2000 and 24 November 2022 concerning EMS and palliative care were included.Data extraction and synthesisTwo independent reviewers screened titles, abstracts and full texts for inclusion. Extracted data underwent descriptive content analysis and were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines.ResultsIn total, 10 725 articles were identified. Following title and abstract screening, 10 634 studies were excluded. A further 35 studies were excluded on full-text screening. The remaining 56 articles were included for review. Four predominant domains arose from included studies: (1) EMS’ palliative care role, (2) challenges faced by EMS in palliative situations, (3) EMS and palliative care integration benefits and (4) proposed recommendations for EMS and palliative care integration.ConclusionEMS have a role to play in out-of-hospital palliative care, however, many challenges must be overcome. EMS provider education, collaboration between EMS and palliative systems, creation of EMS palliative care guidelines/protocols, creation of specialised out-of-hospital palliative care teams and further research have been recommended as solutions. Future research should focus on the prioritisation, implementation and effectiveness of these solutions in various contexts.

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Section: Methodsmentioning

confidence: 99%

Emergency medical services and palliative care: a scoping review

et al. 2023

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“…Some argue palliative paramedicine is not for everyone, but rather for those paramedic 'champions' who have a passion for palliative care. 25,26 We agree with this sentiment, but also call for a generalist palliative care capacity for all paramedics, and specialist roles for those demonstrating interest and aptitude.…”

Section: What This Study Addsmentioning

confidence: 88%

‘It breaks a narrative of paramedics, that we’re lifesavers’: A qualitative study of health professionals’, bereaved family members’ and carers’ perceptions and experiences of palliative paramedicine

Juhrmann,

Butow,

Platts

et al. 2023

Palliat Med

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Background: Paramedic practice is diversifying to accommodate evolving global health trends, including community paramedicine models and growing expertise in palliative and end-of-life care. However, despite palliative care specific clinical practice guidelines and existing training, paramedics still lack the skills, confidence and clinical support to provide this type of care. Aim: To elicit paramedics’, palliative care doctors and nurses’, general practitioners’, residential aged care nurses’ and bereaved families and carers’ experiences, perspectives, and attitudes on the role, barriers and enablers of paramedics delivering palliative and end-of-life care in community-based settings. Design: A qualitative study employing reflexive thematic analysis of data collected from semi-structured online interviews was utilised. Setting/participants: A purposive sample of 50 stakeholders from all Australian jurisdictions participated. Results: Five themes were identified: positioning the paramedic (a dichotomy between the life saver and community responder); creating an identity (the trusted clinician in a crisis), fear and threat (feeling afraid of caring for the dying), permission to care (seeking consent to take a palliative approach) and the harsh reality (navigating the role in a limiting and siloed environment). Conclusion: Paramedics were perceived to have a revered public identity, shaped by their ability to fix a crisis. However, paramedics and other health professionals also expressed fear and vulnerability when taking a palliative approach to care. Paramedics may require consent to move beyond a culture of curative care, yet all participant groups recognised their important adjunct role to support community-based palliative care.

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“…Emergency medical teams aim to save lives and health in emergencies, whereas palliative care aims to prevent or alleviate suffering. These are completely different goals, so EMT activities and palliative care can complement each other [3]. The World Health Organization (WHO) points out that specialist palliative care alone cannot meet the increasing patient demand, which requires familiarity with multiple medical disciplines [4].…”

Section: Original Articlementioning

confidence: 99%

Interventions of Polish Emergency Medical Teams in patients with malignant tumors — a four-year follow-up (2019–2022)

Przybylska,

Burak,

Gołota

2024

Oncol Clin Pract

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Introduction. In Poland, interventions of emergency medical teams in patients with malignant tumors represent a small percentage of all interventions. Patients with malignant tumors constitute a diverse group in which the patient may manifest a wide spectrum of symptoms and complaints affecting different systems and organs. The aim of this study was to retrospectively analyze emergency medical team interventions in patients with malignant tumors. Material and methods. 1174 emergency medical services forms from emergency medical team interventions in patients with malignant tumors from April 2019 to December 2022 in the Kujawsko-Pomorskie voivodship in Poland were analyzed.Results. In the study group 52% were male. The mean age of the subjects was 66 years (SD = 12.31). The most common symptoms in patients were pathological respiratory murmurs (11.7%), psychomotor disorders (11.3%), hypoxemia (10.3%), dyspnea (9.5%) and pain (5.8%). 40.5% of patients were transported to hospital. A total of 7496 emergency medical procedures were performed, most of them involving physical examination and assessment of the patient's condition. The pharmacotherapy administered most commonly involved analgesics (30.9%), electrolytes (24%) and glucocorticosteroids (20.1%). Seventy-four patients (6.3%) died during EMT intervention.Conclusions. Emergency medical teams most often provide assistance to patients with malignant tumors of the respiratory and thoracic organs and organs of the digestive system. The majority of oncology patients do not require hospital treatment, but only outpatient care. Therefore, there is a need to regulate and optimize the actions taken by emergency medical teams when intervening in patients with malignant tumors.

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Emergency medical services and palliative care: protocol for a scoping review

Cited by 4 publications

References 26 publications

Emergency medical services and palliative care: a scoping review

Emergency medical services and palliative care: a scoping review

‘It breaks a narrative of paramedics, that we’re lifesavers’: A qualitative study of health professionals’, bereaved family members’ and carers’ perceptions and experiences of palliative paramedicine

Interventions of Polish Emergency Medical Teams in patients with malignant tumors — a four-year follow-up (2019–2022)

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