Palliative care in paramedic practice: A retrospective cohort study.
Emergency medical services
dying
end-of-life care
palliative care
paramedic
transfers between care settings
Journal
Palliative medicine
ISSN: 1477-030X
Titre abrégé: Palliat Med
Pays: England
ID NLM: 8704926
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
pubmed:
6
2
2019
medline:
17
3
2020
entrez:
6
2
2019
Statut:
ppublish
Résumé
Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic's role in the care of these patients. To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care. This is a retrospective cohort study. Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record. Secondary transfers including inter-hospital transport cases were excluded. A total of 4348 cases met inclusion criteria. Median age was 74 years (interquartile range 64-83). The most common paramedic assessments were 'respiratory' (20.1%), 'pain' (15.8%) and 'deceased' (7.9%); 74.4% ( n = 3237) were transported, with the most common destination being a hospital (99.5%, n = 3221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic, morphine, fentanyl or methoxyflurane, and 356 (99.2%) were transported following analgesic administration. Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 h of the previous attendance. Paramedics have a significant role in caring for patients receiving palliative care. These results should inform the design of integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
Sections du résumé
BACKGROUND
Paramedics may be involved in the care of patients experiencing a health crisis associated with palliative care. However, little is known about the paramedic's role in the care of these patients.
AIM
To describe the incidence and nature of cases attended by paramedics and the care provided where the reason for attendance was associated with a history of palliative care.
DESIGN
This is a retrospective cohort study.
SETTING/PARTICIPANTS
Adult patients (aged >17 years) attended by paramedics in the Australian state of Victoria between 1 July 2015 and 30 June 2016 where terms associated with palliative care or end of life were recorded in the patient care record. Secondary transfers including inter-hospital transport cases were excluded.
RESULTS
A total of 4348 cases met inclusion criteria. Median age was 74 years (interquartile range 64-83). The most common paramedic assessments were 'respiratory' (20.1%), 'pain' (15.8%) and 'deceased' (7.9%); 74.4% ( n = 3237) were transported, with the most common destination being a hospital (99.5%, n = 3221). Of those with pain as the primary impression, 359 (53.9%) received an analgesic, morphine, fentanyl or methoxyflurane, and 356 (99.2%) were transported following analgesic administration. Resuscitation was attempted in 98 (29.1%) of the 337 cases coded as cardiac arrest. Among non-transported cases, there were 105 (9.6%) cases where paramedics re-attended the patient within 24 h of the previous attendance.
CONCLUSION
Paramedics have a significant role in caring for patients receiving palliative care. These results should inform the design of integrated systems of care that involve ambulance services in the planning and delivery of community-based palliative care.
Identifiants
pubmed: 30720392
doi: 10.1177/0269216319828278
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM