Agreement of point-of-care and laboratory lactate levels among trauma patients and association with transfusion.

Background And Objectives: In the setting of trauma and suspected critical bleeding, indications to commence blood transfusions remain unclear, with high rates of potentially avoidable transfusions. Prehospital blood lactate measurements could help predict the need for blood transfusions. The aim of this study was to compare measurements detected by a point-of-care (POC) lactate device with laboratory measured lactate levels.

Cardiac arrest centres for patients with non-traumatic cardiac arrest: A systematic review.

Introduction: Regionalisation and organised pathways of care using specialist centre hospitals can improve outcomes for critically ill patients. Cardiac arrest centre hospitals (CAC) may optimise the delivery of post-resuscitation care. The International Liaison Committee on Resuscitation (ILCOR) has called for a review of the current evidence base.

Paramedic perceptions of conveying patients to an emergency department who were suitable for primary care: a cross-sectional survey.

Background Ambulance callouts and conveyances continue to increase disproportionately to population growth. This is largely driven by low- and medium-acuity patients who do not require ambulance management. We aimed to estimate the proportion of patients paramedics have conveyed to an emergency department (ED) via ambulance whom they considered suitable for primary care, and understand the barriers that contributed to these decisions.

International facets of the 'chain of survival' for out-of-hospital and in-hospital cardiac arrest - A scoping review.

Background: The "chain of survival" was first systematically addressed in 1991, and its sequence still forms the cornerstone of current resuscitation guidelines. The term "chain of survival" is widely used around the world in literature, education, and awareness campaigns, but growing heterogeneity in the components of the chain has led to confusion. It is unclear which of these emerging chains is most suitable, or if adaptations are needed in particular contexts to depict key actions of resuscitation in the 21st century.

Pathology requesting in a regional Australian Emergency Department; an observational study comparing current practice with college guidelines.

Introduction: In 2018, the Australasian College for Emergency Medicine (ACEM) and the Royal College of Pathologists of Australasia (RCPA) produced a guideline to encourage appropriate pathology requesting in the Emergency Department (ED).

Objective: To assess adherence to the ACEM/RCPA pathology testing guideline in a regional ED.

Methods, Design, Setting And Participants: This was a retrospective observational study conducted at a regional Australian ED over 7 days.

Gamified learning for resuscitation education: A systematic review.

Aim: To systematically review published literature to evaluate the impact of gamified learning on educational and clinical outcomes during life support education.

Methods: This systematic review was conducted as part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR). A search of PubMed, Embase, and Cochrane was conducted from inception until February 12, 2024.

Blood lactate after pre-hospital blood transfusion for major trauma by helicopter emergency medical services.

Background And Objectives: The appropriate use of blood components is essential for ethical use of a precious, donated product. The aim of this study was to report in-hospital red blood cell (RBC) transfusion after pre-hospital transfusion by helicopter emergency medical service paramedics. A secondary aim was to assess the potential for venous blood lactate to predict ongoing transfusion.

Diagnostic Accuracy of Posterior Circulation Stroke by Paramedics: A Systematic Review.

Objective: This systematic review aims to identify the diagnostic accuracy of posterior circulation stroke (PCS) by paramedics and the causes and duration of delay in its recognition.

Methods: A systematic search using CINAHL Plus, MEDLINE, Scopus, and PubMed was performed. All databases were searched up to May 25, 2022.

Pre-hospital guidelines for CPR-Induced Consciousness (CPRIC): A scoping review.

Background: CPR-Induced Consciousness is an emerging phenomenon with a paucity of consensus guidelines from peak resuscitative bodies. Local prehospital services have had to implement their own CPR-Induced Consciousness guidelines. This scoping review aims to identify prehospital CPR-Induced Consciousness guidelines and compare or contrast their management options.

Intubation Rates following Prehospital Administration of Ketamine for Acute Agitation: A Systematic Review and Meta-Analysis.

Background: Ketamine is a fast-acting, dissociative anesthetic with a favorable adverse effect profile that is effective for managing acute agitation as a chemical restraint in the prehospital and emergency department (ED) settings. However, some previously published individual studies have reported high intubation rates when ketamine was administered prehospitally.

Objective: This systematic review aims to determine the rate and settings in which intubation following prehospital administration of ketamine for agitation is occurring, as well as associated indications and adverse events.

The Definition of Paramedicine: An International Delphi Study.

Introduction: Although paramedicine is an integral element of healthcare systems, there is a lack of universal consensus on its definition. This study aimed to derive a global consensus definition of paramedicine.

Methods: Key attributes pertaining to paramedicine were identified from existing definitions within the literature.

A bibliometric analysis of paramedicine publications using the Scopus database: 2010-2019.

Background: Paramedicine is an evolving profession undergoing increases in scholarly activity and peer-reviewed publications. This study aims to complete the first extensive bibliometric examination of the worldwide paramedicine literature.

Method: Scopus was utilised to search for paramedicine-based articles published in peer-reviewed journals between 2010 and 2019 inclusive.

Prehospital paramedic pleural decompression: A systematic review.

Background: Tension pneumothorax (TPT) is a frequent life-threat following thoracic injury. Time-critical decompression of the pleural cavity improves survival. However, whilst paramedics utilise needle thoracostomy (NT) and/or finger thoracostomy (FT) in the prehospital setting, the superiority of one technique over the other remains unknown.

Misleading medical literature: An observational study.

Objective: Language that implies a conclusion not supported by the evidence is common in the medical literature. The hypothesis of the present study was that medical journal publications are more likely to use misleading language for the interpretation of a demonstrated null (i.e.

Review article: Paramedic pain management of femur fractures in the prehospital setting: A systematic review.

Femur shaft and neck of femur (NOF) fractures are often undertreated in the prehospital setting. These injuries can present unique clinical and logistical concerns in the prehospital setting. This systematic review aimed to investigate paramedic prehospital pain management of patients who had suffered NOF or femur fractures, and to investigate which interventions are effective.

Top 100 cited paramedicine papers: A bibliometric study.

Objective: Understanding the impact different journal articles have in any academic field is important - particularly in emerging professions. A bibliometric analysis like this does not yet exist for paramedicine, despite the rapid increase in its primary literature. The objective of the present study was to identify and analyse the 100 top-cited articles about paramedicine.

Review article: Pre-hospital provider clinical judgement upon arrival to the emergency department: A systematic review and meta-analysis.

Pre-hospital providers (PHPs) undertake initial patient assessment, often spending considerable time with patients prior to arrival at ED. However, continuity of this assessment with ongoing care of patients in the ED is limited, with repeated assessment in the ED, starting with the process of triage in hospital. A systematic review of the literature was conducted to assess the ability of PHPs to predict patient outcomes in the ED.

Paramedic streaming upon arrival in emergency department: A prospective study.

Objective: The role of paramedics in hospital triage or streaming models has not been adequately explored and is potentially a missed opportunity for enhanced patient flow. The aim of the present study was to assess the concordance between a streaming decision by paramedics with the decision by nurses after arrival to the ED.

Methods: A prospective observational study was conducted.

Lunacy in a tertiary emergency department: A 3-year cohort study of the association between moon cycles and occupational violence and aggression.

Objective: Occupational violence and aggression (OVA) in the ED is an issue of global concern and increasing incidence. The empirical evidence for the relationship between the lunar cycle and 'lunatics' remains equivocal. The present study aims to examine the association between OVA in ED and the full moon (FM).

Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service.

Objective: To determine the frequency of finger thoracostomy performed by intensive care flight paramedics after the introduction of a training programme in this procedure and complications of the procedure that were diagnosed after hospital arrival.

Methods: This was a retrospective cohort study of adult and paediatric trauma patients undergoing finger thoracostomy performed by paramedics on a helicopter emergency medical service between June 2015 and May 2018. Hospital data were obtained through a manual search of the medical records at each of the three receiving major trauma services.