‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

Abstract

Background Overdose response has become an increasingly relevant component of paramedic practice, particularly in light of increased opioid overdose globally. Previous studies have noted gaps in our understanding regarding the unique challenges which paramedics face during this form of pre-hospital emergency care. The aim of this study is to explore and describe the ways in which paramedics experience overdose response, specifically within a community markedly affected by the overdose crisis. Methods Ten participants were recruited from a single ambulance station located in an urban center in Western Canada. Two rounds of semi-structured individual interviews were conducted, and data saturation was found to have been reached. Verbatim transcripts were produced and subject to two rounds of descriptive and pattern coding. A second researcher reviewed all of the codes, with disagreements being handled by discussion until agreement was obtained. Themes were identified, along with a Core Category which seeks to describe the underlying dynamics of overdose response represented in our data. The concept of a Core Category was borrowed from Grounded Theory methodology.

Change in Police Attendance at Overdose Events following Implementation of a Police Non-Notification Policy in British Columbia

“…Calling emergency health services (EHS) (i.e., 911) in the case of overdose is therefore a critical and potentially life-saving intervention [10]. Furthermore, EHS provide a critical response in cases of complications (e.g., overdoses complicated by benzodiazepines in the illicit supply), which are increasingly common in BC [5,11]. Nevertheless, prior studies identified that concerns about police presence and arrests represent a significant barrier to calling 911 in the event of an overdose [10,[12][13][14].…”

The paramedic role in caring for people who use illicit and controlled drugs: A scoping review

“…14 By empowering paramedics with the tools to provide holistic care, we can foster their resilience, purpose and empathy towards people who use drugs, leading to improved wellness, job satisfaction and patient outcomes. 71 The paramedic role exerts a significant influence on a patient's healthcare journey, and it is crucial that we direct research attention to this highly understudied area. 90 Ultimately, holistic models of care can enhance the relationship between paramedics and people who use drugs, driving meaningful progress towards reducing harm and improving health outcomes.…”

“…68 Five major themes identified by a study of paramedic attitudes in Vancouver, BC, included: connecting with patients' lived experiences; occupying roles as clinicians and patient advocates; navigating on-scene hazards; difficulties with transitions of care; and emotional burden of the drug poisoning crisis. 71 The core category discovered from this study was one's capacity to help, identified by a limited capacity to follow up on patients, to emotionally process stressful encounters and to address the needs of a patient who experiences a drug poisoning event. Despite paramedics feeling highly confident in their role as clinical care providers, their capacity to treat the underlying drug use is described as much more limited.…”

Substance Use and the Paramedic Role: A Scoping Review

“…Five major themes identified by a study of paramedic attitudes in Vancouver, BC included: connecting with patients' lived experiences; occupying roles as clinicians and patient advocates; navigating on-scene hazards; difficulties with transitions of care; and emotional burden of the toxic drug crisis (61). The core category discovered from this study was one's capacity to help, identified by a limited capacity to follow up on patients, to emotionally process stressful encounters, and to address the needs of a patient who experiences a drug poisoning event.…”