Paramedic-delivered teleconsultations: A scoping review
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Keywords

paramedic
prehospital
medical control
clinical support
peer support

How to Cite

1.
Armour R, Helmer J. Paramedic-delivered teleconsultations: A scoping review . Australasian Journal of Paramedicine [Internet]. 2021Feb.23 [cited 2021Sep.22];18. Available from: https://ajp.paramedics.org/index.php/ajp/article/view/882

Abstract

Introduction

Progression in the field of paramedicine has resulted in the development of novel roles within the profession, including the role of advanced paramedics providing teleconsultations for frontline paramedics. Little is known about the experience of paramedics providing or receiving teleconsultations. This scoping review aimed to investigate paramedic perceptions of physician and paramedic-delivered teleconsultations.

Methods

A scoping review of MEDLINE, CINAHL and EBM Reviews as well as paramedic-specific journals and the grey literature was conducted. Articles were included if they examined advanced paramedics, paramedics, emergency ambulance crew or emergency medical technicians receiving teleconsultations, or physicians and advanced paramedics providing teleconsultations.

Results

A total of 7461 unique citations were identified. Two citations were ultimately included in the review. One study examined the delivery of teleconsultations by advanced paramedics and one by physicians, both from the perspective of paramedics. Paramedics delivering teleconsultations generally considered the experience to be positive, while those receiving paramedic-delivered teleconsultations felt the level of advice was appropriate and assisted in expanding their own knowledge base. Paramedics receiving physician-delivered teleconsultations reported variable understanding of the unique challenges of out-of-hospital care and tension in the relationship between paramedics and physicians.

Conclusion

Little literature was identified examining the perceptions of paramedics delivering or receiving physician-delivered or paramedic-delivered teleconsultations. Given the continuing expansion of teleconsultation programs for out-of-hospital staff, this represents a significantly understudied area.

https://doi.org/10.33151/ajp.18.882
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References

Edwards M. Pittsburgh’s freedom house ambulance service: the origins of emergency medical services and the politics of race and health. J Hist Med Allied Sci 2019;74:440-66. doi: 10.1093/jhmas.jrz041

Fitzgerald G. Paramedics and scope of practice. MJA 2015;203:240-1. doi: 10.5694/mja.00775

Bigham B, Kennedy S, Drennan I, Morrison L. Expanding paramedic scope of practice in the community: a systematic review of the literature. Prehosp Emerg Care 2013;17:361-72. doi: 10.3109/10903127.2013.792890

Chan J, Griffith L, Costa A, Leyenaar M, Agarwal G. Community paramedicine: a systematic review of program descriptions and training. CJEM 2019;21:749-61. doi: 10.1017/cem.2019.14

Campbell S, Janes S, MacKinley R, et al. Patient management in the emergency department by advanced care paramedics. Healthc Manage Forum 2012;25:26-31. doi: 10.1016/j.hcmf.2011.12.001

Proctor A. Home visits from paramedic practitioners in general practice: patient perceptions. Journal of Paramedic Practice 2019;11. doi: 10.12968/jpar.2019.11.3.115

Mikolaizak A, Simpson P, Tiedemann A, Lord S, Close J. Systematic review of non-transportation rates and outcomes for older people who have fallen after ambulance service call-out. Australas J Ageing 2013;32:147-57. doi: 10.1111/ajag.12023

Ebben R, Vloet L, Speijers R, et al. A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review. Scand J Trauma Resusc Emerg Med 2017;25. doi: 10.1186.s13049-017-0409-6

Ducas R, Wassef A, Jassal D, et al. To transmit or not to transmit: how good are emergency medical personnel in detecting STEMI in patients with chest pain? Can J Cardiol 2012;28:432-7. doi: 10.1016/j.cjca.2012.04.008

Meizoso J, Valle E, Allen C, et al. Decreased mortality after prehospital interventions in severely injured trauma patients. J Trauma Acute Care Surg 2015;79:227-31. doi: 10.1097/TA.0000000000748

Stevanovic A, Beckers S, Czaplik M, et al. Telemedical support for prehospital emergency medical services (TEMS trial): study protocol for a randomized controlled trial. Trials 2017;18:43. doi: 10.1186/s13063-017-1781-2

Rortgen D, Bergrath S, Rossaint R, et al. Comparison of physician staffed emergency medical teams with paramedic teams assisted by telemedicine – a randomized controlled simulation study. Resuscitation 2013;84:85-92. doi: 10.1016/j.resuscitation.2012.06.012

Raaber N, Botker M, Riddervold I, et al. Telemedicine-based physician consultation results in more patients treated and released by ambulance personnel. Eur J Emerg Med 2018;25:120-7. doi: 10.1097/MEJ.0000000000426

Tintinalli J, Strapczynski J, Ma O, et al. Tintinalli’s Emergency Medicine. 8th edn. New York: McGraw Hill; 2016.

Urgent and Emergency Care Review Programme Team. Clinical models for ambulance services. London: National Health Service England; November 2015. Available at: www.nhs.uk/NHSEngland/keogh-review/Documents/UECR-ambulance-guidance-FV.pdf [Accessed December 2019].

Knowles E, Bishop-Edwards L, O’Cathain A. Exploring variations in how ambulance services address non-conveyance: a qualitative interview study. BMJ Open 2018;8:e024228. doi: 10.1136/bmjopen-2018-024228

Provincial Health Service Authority (PHSA). Paramedic specialists – an innovation out of the overdose crisis. Vancouver: PHSA; August 2019. Available at: www.phsa.ca/about/news-stories/stories/paramedic-specialists-%E2%80%93-an-innovation-out-of-the-overdose-crisis [Accessed December 2019].

Sucharew H, Macaluso M. Methods for research evidence synthesis: the scoping review approach. J Hosp Med 2019;14:416-8. doi: 10.12788/jhm.3248

Munn Z, Peters M, Stern C, et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018;18. doi: 10.1186/s12874-018-0611-x

Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19-32. doi: 10.1080/1364557032000119616

Peters M, Godfrey C, McInerney P, et al. Chapter 11: Scoping reviews. JBI Manual for Evidence Synthesis 2020. doi: 10.46658/JBIMES-20-12

Jackson M, Jones C. Kerbside consultations: advice from the advanced paramedic to the frontline. Journal of Paramedic Practice 2013;4. doi: 10.12968/jpar.2012.4.9.526

Foerster C, Tavares W, Virkkunen I, Kamarainen A. A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight. CJEM 2018;20:238-46. doi: 10.1017/cem.2017.36

Reay G, Rankin J, Smith-MacDonald L, Lazarenki G. Creative adapting in a fluid environment: an explanatory model of paramedic decision making in the pre-hospital setting. BMC Emerg Med 2018;18. doi: 10.1186/s12873-018-0194-1

Givati A, Markham C, Street K. The bargaining of professionalism in emergency care practice: NHS paramedics and higher education. Adv Health Sci Educ Theory Pract 2018;23:353-69. doi: 10.1007/s10459-017-9802-1