To handle the unexpected – The meaning of caring in pre-hospital emergency care

Perceptions of paramedics and emergency staff about the care they provide to people who self-harm: Constructivist metasynthesis of the qualitative literature

“…Ahl and Nyström [31] found that the initial encounter with a pre-hospital care provider is of vital importance, with the potential for satisfaction as well as dissatisfaction with care and outcomes. Participants initially regarded an ambulance as a means of transport rather than a place for care, when treatment was felt to delay care, frustration and anger emerged, with a patient telling, I became frustrated .…”

“…This is important in self-harm, recognizing that the first point of contact with those who self-harm is paramount, and one which will have a bearing on future acceptance of care and can sometimes lead to avoiding emergency services (RCP 2010) [2]. Feelings of safety often emerged in Ahl and Nyström's paper [31], which highlighted that on arrival of the ambulance staffed by pre-hospital nurses, a secure basis for trust and confidence was created. One pre-hospital nurse said, Now you are my patient and to me you are the most important person in my life at the moment as a caregiver.…”

Elderly patients’ participation in emergency medical services when offered an alternative care pathway

“…Their fear makes them immediately want to go to hospital for help, as uncertainty about their survival grows in intensity (Bowman, 2001). An ambulance is requested when the patients are incapable of making the journey on their own and the ambulance arrival is perceived as a guarantee of getting to hospital (Ahl & Nyström, 2012). …”

Paramedics’ perceptions of caring for those who self-harm: A Qualitative Study

“…Whilst many of these studies included paramedics, they did not relate to mental health or SH, and in discussions between the reviewers it was acknowledged their applicability was limited and may be considered a threat to achieving theoretical connectedness, and therefore provided limited contribution to theory development. This was in contrast to higher quality studies (Shaban 2005a, Roberts & Henderson 2009, Ahl & Nyström 2012, Nurok,& Henckes (2009, where mental health or SH may not have been the focus of the study, but did feature within the text, thus adding to theoretical connectedness and providing contribution to theory development. Heuristic relevance of these higher quality studies also resulted in higher ratings due to a wide range of other factors, such as intuitive recognition where the reviewers immediately recognized the phenomenon being described and its relationship to a theoretical perspective in paramedic care for people who SH.…”

“…The antecedents of establishing a safety zone and trading off patient care and scene safety, clearly come from a stated stigma toward mental health and the perceived danger mitigated by the social process of reducing uncertainty through social relations, and in this case involvement of the police. Ahl and Nyström (2012) also found that the initial encounter with a pre hospital care provider is of vital importance, with the potential for satisfaction as well as dissatisfaction with care and outcomes. Patient's interviewed in the study by Ahl and Nyström (2012) initially regarded an ambulance as a means of transport rather than a place for care; when treatment was felt to delay care, frustration, and anger emerged, with a patient telling:…”