Paramedic delivery of community-based palliative care: An overlooked resource?

Abstract

Paramedics are increasingly seen as an integral component of health systems in high income countries. This editorial discusses the factors driving the evolution of paramedicine and the role paramedics may play in the delivery of community-based palliative care. The challenges facing paramedics in palliative care contexts are reviewed briefly. Ultimately, this editorial argues that paramedics are important stakeholders in the delivery of community-based palliative care and have been a notable omission in health service policy and planning.

Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis

“…However, their scope of practice has traditionally been limited to providing life-sustaining interventions for acute emergencies and conveyance to hospital. [5][6][7] For patients who have a progressive life-limiting condition, an acute hospital admission may not be desired or the best setting in which to deliver appropriate palliative care.…”

“…However, there is not a strict dichotomy between these two models. Specialised community paramedic roles are emerging in countries following a paramedic-led ambulance approach to facilitate holistic home-based palliative care, 6 and ambulance services world-wide are adopting clinical protocols to guide end-of-life care, 10 albeit in a variable manner. Other researchers have reviewed the attitudes and perceptions of paramedics delivering palliative care in community-based settings, 11 and provided practical strategies to integrate palliative care into prehospital models of care.…”

Palliative Care Within the Primary Health Care Setting in Australia: A Scoping Review

“…Paramedics play an important role in community-based palliative care [ 36 ], their role is to treat patients who are experiencing health problems related to palliative care, such as pain and respiratory distress [ 37 ]. With Extended Care Paramedics responding to palliative care emergencies, and preventing unwanted and unnecessary hospitalisations [ 38 ].…”

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

“…1 For example, EMS systems have played increasingly important roles in the provision of community-based primary healthcare. 2 As part of this community care, there has recently been a greater recognition of the role EMS systems play in the provision of palliative care. [2][3][4][5] The growing body of literature in this field recommends EMS and palliative systems should integrate to improve palliative care provision in the out-of-hospital setting.…”

“…2 As part of this community care, there has recently been a greater recognition of the role EMS systems play in the provision of palliative care. [2][3][4][5] The growing body of literature in this field recommends EMS and palliative systems should integrate to improve palliative care provision in the out-of-hospital setting. [6][7][8] The World Health Organisation (WHO) defines palliative care as 'an approach that improves the quality of life (QoL) of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.'…”