Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre...

Area of Science:

• Emergency Medicine
• Palliative Care
• Medical Ethics

Background:

• Advance directives and palliative crisis cards empower palliative care patients in end-of-life decision-making.
• Paramedics play a crucial role in prehospital end-of-life care scenarios.

Purpose of the Study:

• To investigate paramedics' perspectives on advance directives and end-of-life care.
• To identify training needs and suggestions for improving prehospital end-of-life decision-making.

Main Methods:

• A questionnaire-based survey was administered to paramedics in Hamburg and Goettingen, Germany.
• Participants shared experiences with advance directives, resuscitation, and palliative crisis cards.

Main Results:

• 728 paramedics responded (81% response rate), with 71% having experience in emergency end-of-life situations.
• 84% deemed cardiopulmonary resuscitation in end-of-life patients ineffective; 75% would withhold it if legally permissible.
• Paramedics called for more training on legal aspects of advance directives and suggested integrating palliative crisis cards into care.

Conclusions:

• Prehospital end-of-life decision-making presents challenges for paramedics.
• A dialogue between emergency medical services and palliative care is essential.
• Paramedics feel inadequately trained in end-of-life care and advance directive content, highlighting a need for improved curricula and guidelines.