Palliative care in paramedic practice: A retrospective cohort study

Area of Science:

• Emergency medical services
• Palliative care
• Health services research

Background:

• Paramedic involvement in palliative care crises is common, yet their specific role remains under-researched.
• Understanding paramedic encounters with palliative care patients is crucial for service improvement.

Purpose of the Study:

• To determine the incidence and characteristics of emergency cases involving patients with a palliative care history attended by paramedics.
• To analyze the care provided by paramedics in these specific patient encounters.

Main Methods:

• Retrospective cohort study of adult patients attended by paramedics in Victoria, Australia (July 2015-June 2016).
• Inclusion criteria focused on cases with recorded palliative or end-of-life care terms, excluding inter-hospital transfers.
• Data analysis involved examining patient demographics, paramedic assessments, interventions, and transport decisions.

Main Results:

• 4348 cases met criteria; median age was 74 years.
• Most common assessments included respiratory issues (20.1%), pain (15.8%), and deceased status (7.9%).
• 74.4% of patients were transported to hospital; analgesia was administered to 53.9% of those with pain, with subsequent transport in 99.2%.

Conclusions:

• Paramedics play a substantial role in the care of patients receiving palliative care.
• Study findings underscore the necessity for integrating ambulance services into the planning and delivery of community-based palliative care.
• Results can inform the development of more cohesive healthcare systems supporting palliative patients at home.