Introduction Children with head injury are commonly transported to the ED by ambulance. However, most of those conveyed are deemed non-serious and are discharged at triage. Research is needed to explore the factors that influence paramedics when deciding to convey children with minor head injury to the ED, and to establish whether a clinical decision tool designed to support them would be beneficial. Methods A generic qualitative approach, comprising semistructured interviews with front-line ambulance paramedics working in the UK. Interviews were audio-recorded and transcribed. Data were analysed using reflexive thematic analysis. Interviews aimed to explore the factors that influence paramedics when deciding to convey children with minor head injury to the ED. Results A total of 20 paramedics from several ambulance services participated in interviews. Three overarching themes were identified: ‘we just take them in’; ‘there are too many hurdles’; ‘creating the right tool’. These were further categorised into subthemes. Paramedics do not feel confident when assessing and managing children with head injury, and convey children to hospital due to fear of consequences, despite knowing there will be no intervention in the ED. Further education, a prehospital paediatric clinical decision tool and greater support from Ambulance Trusts would be welcomed by paramedics. Criteria such as: parental anxiety; time; wound closure; policy and non-accidental injury need to be considered in a clinical decision tool designed to support paramedics’ management of children with head injury. Conclusion Paramedics generally feel a lack of confidence in assessing and managing children with head injury. A decision tool, coupled with training and useful feedback from EDs following conveyance, would be useful to help improve decision-making.
To develop a structured IPE framework for the DiMM curriculum, enhancing interdisciplinary collaboration and improving patient outcomes in mountain medicine education.
Every year in England, there are around 8 million calls to the ambulance service. Only around 1 in 10 of these will be a serious emergency. The rest might have a health need that requires a different level of care - such as from a GP, pharmacist, or nurse. Some may even be patients that paramedics can treat and leave at home. It is hard for ambulance staff to work out what the exact care need of the complex patient is. There are lots of reasons for this, such as limited access to that patient's health data and a lack of available technology. In this study, we want to know what ambulance people think about the use of technology in these patients. The new knowledge from this study will help us understand why ambulance services are not using them to identify the care needs. We will ask lots of different types of ambulance people. These might be paramedics who respond in an ambulance. They could also be people who make the decisions on what technology goes on an ambulance. The way we will be asking all these people is through an interview. This lets us ask lots of questions to everyone, making sure we get all their views and beliefs. We can then look at all the answers and find what they all agree and disagree on about the topic. The way we have designed the study allows us to take the sample and generalise it to all UK ambulance services. This means the results will lead to a new way of thinking about how to bring this technology to the clinicians who need it, and to the patients who could benefit from it. Once we can work out the answers to these questions, we can start to create new care plans and help these patients in a meaningful way.
This study will explore how real-time feedback affects ambulance clinicians’ ability to perform ventilations during a simulated cardiac arrest scenario over six months. Ventilations, typically given via a bag-valve-mask (BVM), are a basic life support skill performed by paramedics in emergency situations, but evidence suggests that many clinicians struggle to deliver ventilations according to guidelines. Feedback during training can help improve these skills, but without regular updates or refresher training, the skills may deteriorate over time. The study will involve participants from a single ambulance service, randomly assigned to three groups. All of these groups will participate in a simulation using a resuscitation manikin. The first group will receive feedback on their ventilations at every session, the second will receive feedback only at the first session, and the third will receive no feedback and act as a control. Ventilation rates and volumes will be measured using a Zoll X-series monitor, which provides real-time feedback. The main aim of the study is to compare the quality of ventilations at the six-month mark between the three groups. A secondary focus will be tracking any changes in ventilation quality across the six months, to identify potential skill improvements or fade.
To adequately prepare graduates for the dynamic demands of paramedic practice, adopting a contemporary educational approach is essential. This involves collaborating to identify crucial competencies through input from industry stakeholders, experienced practitioners, and discipline-specific experts. Accreditation assumes a central role within this framework, serving as a cornerstone to ensure that paramedicine curricula align with paramedics' diverse and evolving professional roles. Methods A narrative review of the literature and a directed search of grey literature were performed to identify specific developments in paramedicine competencies and scope of practice and mapped to the professional capabilities published by the Paramedicine Board of Australia. In determining a competency map and accreditation’s role in a competency framework specific to current and evolving paramedic practice, key documents were analysed using a qualitative approach based on content analysis to identify common traits among documents, countries and other professions. Results The review process identified 278 themes that were further allocated to 22 major analytical groupings. These groupings could further be mapped to previously reported cognitive, technical, integrative, context, relationship, affective/moral competencies and habits of mind. At the same time, the highest-rated groupings were key competencies of intellectual skills, safety, accountability, clinical decision-making, professionalism, communications, team-based approach and situational awareness. Two groups were represented in the literature but not in the professional capabilities, namely Health and Social continuum and self-directed practice. Conclusions This review highlights the importance of measuring and validating the professional capabilities of Paramedicine Practitioners. The study explores various metrics and competency frameworks used to assess competency, comparing them against national accreditation schemes' professional capability standards. The findings suggest that accreditation frameworks play a crucial role in improving the quality of paramedicine practice, encompassing intellectual skills, safety, accountability, clinical decision-making, professionalism, communication, teamwork, and situational awareness.
Paramedicine is undergoing a rapid change on a steep trajectory in a short time. Indeed, there is still a widely held view that paramedicine and ambulance services are two of the same thing, but the reality is starkly different. Whilst much attention is focused on the front-line of paramedicine through the lens of emergency ambulance services, there is a paucity of any real insight into the upper echelons in the corridors of power and influence of and within the profession and associated linked ecologies. Professionalisation has been at the forefront of the profession's agenda for many years - developing organically, with no apparent clear or directed strategy. Indeed, whilst paramedicine demonstrates many of the classic hallmarks of a profession as seen in classic sociology of professions literature (McCann, 2022, Leicht and Fennell, 2001, Muzio et al., 2019), this development has not been in congruence with all parts of the sum. Paramedics in the UK are represented by, and regulated by UK-wide bodies – but work in increasingly stratified areas: 3 national, ten regional ambulance services in four public healthcare bodies reporting to four different governments – let alone outside the ambulance sector. With the profession no longer limited to its historical organisational home how can, and more importantly, does the profession have a strategy (Hambrick and Fredrickson, 2005) and who “owns” it? To date, research into the paramedic profession has almost exclusively focused on the operational frontline clinicians (McCann, 2022). This study aims to ask the following key research questions, at a senior/strategic level. Given the focus on strategic and system level thinking in the wider NHS at this time, this work is critical to add to this area of importance. • How is the paramedic profession pursuing a professionalisation strategy? • What are the roles and implications for different constituents in this process? • How can we understand the boundaries of the profession's claimed “scope/territory”? • How can we evaluate the possible success/failures of the strategy?
This study explores how family members experience and perceive bereavement care provided by the ambulance service when a loved one dies in the pre-hospital setting. Bereavement care refers to the support provided to families after the death of a loved one. The study aims to understand what families need during this time and how ambulance services can improve their support. We will invite people who, in the past two years, have lost a family member while receiving care from the ambulance service. This includes cases where the patient died at the scene or shortly after being transported to the hospital. The two-year time frame ensures that experiences reflect current practices, without focusing on care during the COVID-19 pandemic. Participants will be interviewed either in person at a local ambulance service site or online via Microsoft Teams. The interviews will explore family members' experiences and what they felt was helpful or could have been done differently. Each interview will last between 30 and 60 minutes, and all responses will be anonymised to protect participants’ privacy. The results will be analysed to identify themes about what families value and need during this difficult time. This will help the ambulance service improve how it supports grieving families. We will recruit participants through posters in healthcare settings, social media, and partnerships with bereavement charities. Participation is voluntary, and people can withdraw at any point up to 24 hours after the interview. The study aims to highlight family members’ voices to ensure bereavement care is compassionate and meets their needs. Findings will be shared with the ambulance service and published to improve care standards.
The study investigates paramedics’ coping actions for sustainable long-term work performance and burnout prevention. The research focuses on what individuals are doing to cope with their day-to-day stressors and the actions they take that may contribute to recovery and be protective against burnout. The research will involve short interviews to collect the data which should take 30 minutes. The interview will be conducted online (e.g. via Microsoft Teams). During the interview, the participant will be asked a series of questions about their experience of their job as a paramedic. Specifically, we will ask about day-to-day responsibilities, how individuals cope with these and if there are any challenges to applying coping strategies. With permission, the interview will be recorded, but participants can choose to keep their cameras off if they wish. Inclusion criteria: current or former practising paramedics, aged 18 and over, who can give informed consent. Exclusion criteria: Paramedic Students or individuals currently diagnosed with and receiving treatment for mental health disorders, such as burnout, mood and anxiety disorders.
West Midlands Ambulance Service crews are taking blood and saliva samples at first point of contact with suspected stroke patients. These are then tested in University of Birmingham facilities to see if we can identify stroke biomarkers in these ultra-early samples.
This research aims to assess the impact of Community First Responder (CFR) involvement on the outcomes of Out-of-Hospital Cardiac Arrest (OHCA) cases within the North East Ambulance Service (NEAS) region. The study will focus on the Return of Spontaneous Circulation (ROSC) rate, alongside secondary outcomes such as bystander interventions and clinical management metrics, comparing CFR-attended and non-CFR-attended cases. It will also examine the specific impact of the Newcastle University First Responder Scheme on OHCA outcomes. The project will analyse routinely collected OHCA data from 2019 to 2024, using a retrospective cohort design. The primary aim is to investigate whether CFR involvement leads to improved ROSC rates and other clinical outcomes. A secondary focus will be on exploring the effectiveness of the Newcastle University CFR scheme within the NEAS region. Building on a 2023 analysis of urban and rural OHCA outcomes, this study will expand the dataset to five years of data. This broader scope will allow for a more detailed exploration of CFR impact, specifically whether CFR intervention is linked to improved ROSC at hospital. The study will use anonymised data from NEAS’s OHCA audit database, including key variables such as CFR dispatch status, bystander CPR, and ROSC rates. Statistical analyses using SPSS will compare outcomes between CFR and non-CFR cases, adjusting for confounders like demographics and response times. The findings will add to the evidence base on the role of CFRs in OHCA care, providing insights into their effectiveness in improving clinical outcomes. These results will inform future initiatives involving CFRs. The research will be disseminated through peer-reviewed publications to the British Paramedic Journal, conference presentations, and internal reports to NEAS and other CFR schemes. This research has received funding from the College of Paramedics small research grant.
The EPiCC study aims to better understand the challenges and opportunities around equality, diversity, and inclusion (EDI) in prehospital critical care roles—jobs like those held by paramedics and doctors in air ambulance and ambulance services. While more women have entered emergency medical services in recent years, people from minority ethnic groups and other underrepresented backgrounds are still not well represented, especially in high-level critical care positions. This research will collect survey responses from clinicians currently in critical care roles, those aiming for these roles, and those who have tried but not succeeded. The study will explore their experiences—both positive and negative—to identify what helps and what hinders a diverse and inclusive workforce. The goal is to provide clear insights that ambulance services and other employers can use to create fairer and more supportive working environments. By improving diversity and inclusion in these high-stakes medical teams, we hope to support staff wellbeing, improve career access for underrepresented groups, and ultimately deliver better patient care.
The demand for mental health support in England has risen sharply in recent years, exceeding the capacity of available services. Approximately 1.2 million people are currently on NHS community mental health waiting lists, placing increased strain on paramedics, who now spend an estimated 1.8 million hours annually responding to mental health-related calls. As frontline responders, paramedics play a critical role in providing urgent care to individuals experiencing mental health difficulties. However, existing research highlights that paramedics tend to feel frustration, uncertainty, and lack of confidence when managing patients with mental health presentations. Despite this, there is currently no standardised mental health education or training requirement for paramedics in England, and limited research has explored the specific knowledge gaps that hinder their ability to provide effective care. This study aims to identify and assess the knowledge gaps and educational needs of paramedics regarding mental health care. Findings will inform the development of targeted educational initiatives, equipping paramedics with the necessary skills to improve patient outcomes and bridge gaps in pre-hospital mental health care.