• Preparation for Frontline End-of-Life Care: Exploring the Perspectives of Paramedics and Emergency Medical Technicians

    by Alan Batt. Last modified: 24/02/14

     
    Waldrop DP1, Clemency B, Maguin E, Lindstrom H. Preparation for Frontline End-of-Life Care: Exploring the Perspectives of Paramedics and Emergency Medical Technicians. J Palliat Med. 2014 Feb 11. PMID: 24517266.

    Abstract

    Background

    Prehospital emergency providers (emergency medical technicians [EMTs] and paramedics) who respond to emergency calls for patients near the end-of-life (EOL) make critical decisions in the field about initiating care and transport to an emergency department.

    Objective

    To identify how a sample of prehospital providers learned about EOL care, their perceived confidence with and perspectives on improved preparation for such calls.

    Design

    This descriptive study used a cross-sectional survey design with mixed methods.

    Setting/Participants

    One hundred seventy-eight prehospital providers (76 EMT-basics and 102 paramedics) from an emergency medical services agency participated.

    Measurements

    Multiple choice and open-ended survey questions addressed how they learned about EOL calls, their confidence with advance directives, and perspectives on improving care in the field.

    Results

    The response rate was 86%. Education about do-not-resuscitate (DNR) orders was formal (92%), experiential (77%), and self-directed (38%). Education about medical orders for life-sustaining treatment (MOLST) was formal (72%), experiential (67%), and self-directed (25%). Ninety-three percent were confident in upholding a DNR order, 87% were confident interpreting MOLST, and 87% were confident sorting out conflict between differing patient and family wishes. Qualitative data analysis yielded six themes on improving preparation of prehospital providers for EOL calls: (1) prehospital provider education; (2) public education; (3) educating health care providers on scope of practice; (4) conflict resolution skills; (5) handling emotional families; and (6) clarification of transfer protocols.

    Conclusion

    These study results suggest the need for addressing the potential interrelationship between prehospital and EOL care through improved education and protocols for care in the field.

    References

     
    1.

    Waldrop DP1, Clemency B, Maguin E, Lindstrom H. Preparation for Frontline End-of-Life Care: Exploring the Perspectives of Paramedics and Emergency Medical Technicians. J Palliat Med. 2014 Feb 11. PMID: 24517266.

    The following two tabs change content below.
    Alan Batt

    Alan Batt

    Paramedic, educator, researcher
    Alan is a critical care paramedic, paramedic educator and prehospital researcher, currently working around the world as an educator and researcher. He has previously worked and studied across Europe, North America and the Middle East. He holds a Graduate Certificate in Intensive Care Paramedic Studies, and an MSc in Critical Care. His main interests are in care of the elderly, end-of-life care, patient safety, professionalism (including role and identity), and paramedic education.

    Tags: , , , ,

    Leave a Reply