I was recently asked by the National Institute for Health Research (NIHR) Dissemination Centre to write a blog on their new themed review on research in prehospital care. I’ve re-posted the blog here, or you can look at it on their website by clicking here. They also filmed a video that I make an appearance in.
I was giving a lecture recently to a group of student paramedics about prehospital research – why it’s an exciting, developing area to work in and why it’s so important for patients that we do it. I was trying to explain that, historically, prehospital care had probably been behind many other specialities in health care and medicine when it comes to research, but that in recent years there had been an increase in the amount of good, high quality evidence being conducted in the prehospital and emergency setting.
At the time I was speaking to this group of students, Care at the scene, a themed review published the National Institute for Health Research (NIHR) Dissemination Centre (@NIHR_DC) hadn’t been released yet, but it would have demonstrated this point perfectly.
Their themed review brings together recent research evidence on urgent and emergency care, focussed on the ambulance service. They organised almost 40 NIHR funded studies into three main areas – understanding system and population factors that affect ambulance services; decision-making by patients, ambulance staff and services, workforce and patient experience; and clinical interventions in prehospital care.
Rather than write a summary of the findings of the review, you can click here and read it for yourself. But what I would like to do is talk about why I’m so pleased this piece of work has been published and why it’s so important.
The role of ambulance service staff and the care they provide for patients has seen a paradigm shift in the last couple of decades. From historically adhering to the ‘load-and-go’ ethos of ‘ambulance drivers’, to now delivering high levels of care and sophisticated interventions on scene. Not only has the level of acute-care advanced, but the ambulance service is now considered part of the wider system of urgent and emergency care services. We are treating more and more patients with complex health and social needs, long-term and chronic conditions.
Not only this, but with emergency departments under such relentless demand, the ambulance service has a part to play in ensuring patients are being seen and treated at the most appropriate place; whether that be at home, minor injury units, GP surgeries etc. Staff are undertaking more training to gain specialist skills and new approaches to managing patients at scene.
As the landscape of what we do as an ambulance services changes, we also need the research and evidence to show that the care we provide is effective, beneficial, safe and cost-effective. As a clinician, this review has highlighted important studies that can influence my practice and make sure I’m providing evidence-based care for the patients I see.
As a paramedic involved in research, I’m so encouraged to read about the variety of great studies that have happened and are ongoing. It shows how research plays such an important role in improving ambulance services and care patients receive. It’s great to see that a range of well conducted research is being undertaken covering the different aspects involved in prehospital care, from large randomised controlled trials focussing on cardiac arrest, to qualitative studies looking at decision-making and safety in ambulance service transitions. And while it’s encouraging to see this research being done, it also highlights the fact that more research is still needed.