Australasian Journal of Paramedicine 2022-06-06T21:59:36-07:00 Amy Hutchison Open Journal Systems <p style="margin: 0cm 0cm 0pt;"><span style="font-family: Times New Roman; font-size: medium;"><span style="font-family: Times New Roman; font-size: medium;">The Australasian Journal of Paramedicine (the AJP) is the official open access, peer-reviewed, international journal of the Australasian College of Paramedicine (formerly Paramedics Australasia), the peak professional body representing paramedics throughout Australasia. </span></span></p> <p style="margin: 0cm 0cm 0pt;"><span style="font-family: Times New Roman; font-size: medium;"> </span></p> <p style="margin: 0cm 0cm 0pt;"><span style="font-family: Times New Roman; font-size: medium;">The AJP aims to advance and promote the science of pre-hospital care research, management, education, clinical practice, policy and service delivery, as well as provide a forum to respond to the professional interests of the multidisciplinary pre-hospital care community.</span></p> <p style="margin: 0cm 0cm 0pt;"><span style="font-family: Times New Roman; font-size: medium;"> </span></p> <p style="margin: 0cm 0cm 0pt;"> </p> Australasian College of Paramedicine International Conference (ACPIC) 2021 Abstracts 2022-06-06T21:59:36-07:00 Australasian College of Paramedicine Scientific Committee 2022-06-13T00:00:00-07:00 Copyright (c) 2022 Australasian College of Paramedicine Scientific Committee A new era of opportunity – securing excellence for our Journal 2022-04-05T00:10:11-07:00 Paul Simpson <p><em>“Change is the law of life, and those who look only to the past or present are certain to miss the future.”</em></p> <ul> <li><em>John F Kennedy</em></li> </ul> <p>The Australasian College of Paramedicine (ACP) has a distinguished history of supporting, promoting and disseminating research in paramedicine. Central to that outcome has been its longstanding commitment to scientific journal publishing by way of what is currently our journal, the Australasian Journal of Paramedicine.</p> <p>In November 2021, AJP commenced a hiatus on new submissions that will continue until mid-2022. An interim Editor in Chief, Associate Professor Paul Simpson, was appointed to oversee the operations concurrent to a transition strategy being developed. A Journal Advisory Committee (‘JAC’) with international membership was tasked to advise the College on the future direction of the College’s Journal. The JAC have consulted widely with researchers in and outside of paramedicine, and with experienced leaders in the journal publishing space, to identify best practice models that will be sustainable and give the Journal the best opportunity to grow and prosper into the future.</p> <p>It is expected that the new Journal will launch in early 2023, heralding a new decade of excellence and progression with a stronger international focus and a resolute commitment to progressing the scientific discourse in paramedicine. The reopening of submissions for the first edition of the relaunched journal is expected in October 2022.</p> 2022-04-08T00:00:00-07:00 Copyright (c) 2022 Paul Simpson Clinical presentations, physician consultations and patient transport options for Australian remote and industrial paramedics 2022-04-13T05:03:37-07:00 Tania Johnston Joseph Acker <p><strong>Introduction</strong></p> <p>The aim of this study was to provide a snapshot of Australian remote and industrial paramedics’ patient clinical presentations, experience with physician consultations and options for patient transport to tertiary care.</p> <p><strong>Methods</strong></p> <p>This exploratory, cross-sectional descriptive study employed a purpose-built online survey. Participants were 78 paramedics working in Australian rural and remote industrial settings recruited in 2015 using web-based, respondent-driven sampling. In addition to a series of closed ended questions, respondents were asked to recall the number of times they encountered specific clinical presentations during the past year. Data were analysed using descriptive statistics and modes were calculated for ordinal data associated with clinical presentations.</p> <p><strong>Results</strong></p> <p>The traumatic presentations that participants recalled encountering at least 10 times the preceding year included back pain (39.7%), minor lacerations (38.5%), joint (36.4%) and hand (30.8%) injuries. Respondents selected headache (64.1%), nausea, vomiting or diarrhoea (52.6%), respiratory infections (50%), ear, nose or throat problems (43.6%) and localised infections or rash (39.7%) as the most common medical presentations. Of the respondents, 38.4% managed patients with mental health presentations a minimum of six times in the preceding year, and 45.3% treated at least one patient in cardiac arrest. While 94.8% of participants said topside support was available, over half described consulting physicians infrequently and if they did, it was typically by telephone. Most respondents (61%) indicated that their worksite was located over 100 km from a hospital.</p> <p><strong>Conclusion </strong></p> <p>Survey findings indicate that paramedic participants recall encountering a wide range of clinical presentations and managing low acuity illnesses more commonly than traumatic injuries. Most respondents were located at least 100 km from the nearest hospital and although almost all had access to topside support, over half stated they consulted physicians infrequently. </p> 2022-07-27T00:00:00-07:00 Copyright (c) 2022 Tania Johnston, Joseph Acker Contrapower harassment in paramedicine: Experiences of academic staff in Australian universities 2021-11-03T21:40:39-07:00 Brett Williams Christine King Malcolm Boyle Lisa Clegg Scott Devenish Catherine Kamphuis James King David Reid <p><strong>Background</strong></p> <p>Although bullying and harassment among academic staff has been well researched, research on students bullying and harassing academic teaching staff (ie, contrapower harassment) is less common. Contrapower harassment has been on the rise in academia over the last decade, partly attributable to changes in the student–faculty staff relationship. This study aimed to understand better the extent and impact of students’ contrapower harassment on paramedic academic teaching staff within Australian universities, as well as actions and interventions to address it.</p> <p><strong>Methods</strong></p> <p>This study used a two-phase mixed methods design. In phase 1, a convenience sample of paramedic teaching academics from 12 universities in Australia participated in an online questionnaire. In phase 2, an in-depth interview was conducted with nine participants from phase 1.</p> <p><strong>Results </strong></p> <p>Seventy-six academic teaching staff participated in the study. Survey results showed that most academics surveyed had experienced harassment from paramedic students, with the highest incidence of harassment occurring during student assessment periods. Alarmingly, over 30% of the academics surveyed had been ‘stalked’ by a student and over 50% had felt powerless and helpless when students had attacked them on social media. Problematic students were identified as those who presented with an over-inflated sense of entitlement or with psychological states and traits that find it challenging to accept feedback and failure, and look to externalise their failures. Reasons for increases in contrapower harassment included a complex mix of consumer and demand-driven education, on-demand (and demanding) instant gratification and degree self-entitlement, and an increase in social media and online learning (particularly during the COVID-19 pandemic of 2020).</p> <p><strong>Conclusion</strong></p> <p>Although most of the academics in this study experienced contrapower harassment by students, they also report that most students are level-headed and supportive, and do not carry out this type of harassment. Promoting student professionalism and reassessing student evaluations are starting points for addressing this type of harassment. Further research on the broader systemic issues that influence the contributors to contrapower harassment is needed.</p> 2022-08-10T00:00:00-07:00 Copyright (c) 2022 Brett Williams, Christine King, Malcolm Boyle, Lisa Clegg, Scott Devenish, Catherine Kamphuis, James King, David Reid Australasian College of Paramedicine Student Conference (StuCon 2021) Abstracts - Oral and Poster Presentations 2021-08-03T00:10:08-07:00 Liam Bruton <p>These are the conference abstracts for oral and poster presentations at the Australasian College of Paramedicine Student Conference (StuCon 2021) Abstracts, Virtual online, Australia, 30th July 2021</p> 2021-08-19T00:00:00-07:00 Copyright (c) 2021 Liam Bruton Comparison of two pre-hospital stroke scales to detect large vessel occlusion strokes in Australia: A prospective observational study 2021-09-14T00:12:41-07:00 Cecilia Ostman Carlos Garcia-Esperon Thomas Lillicrap Khaled Alanati Beng Lim Alvin Chew Jennifer Pedler Sarah Edwards Mark Parsons Christopher Levi Neil Spratt <p><em>Aims:</em> The Hunter-8 and the ACT-FAST are stroke scales used in Australia for the pre-hospital identification of large vessel occlusion (LVO) stroke but have not previously been compared. Moreover, their use in identifying distal arterial occlusions has not previously been assessed. We therefore aimed to describe the area under the receiver operating curve (AUC) of the Hunter-8 versus the ACT-FAST for the detection of classic LVO.</p> <p><em>Methods:</em> Both scales were performed on consecutive patients presenting with stroke-like symptoms within 24 hours of symptom onset presenting to the emergency department at a tertiary referral hospital between June 2018 and January 2019. The AUC of the Hunter-8 and the ACT-FAST was calculated for the detection of LVO using different definitions [classic LVO (proximal segment of the middle cerebral artery (MCA-M1), terminal internal carotid artery (T-ICA), or tandem occlusions) and extended LVO (classic LVO plus proximal MCA-M2 and basilar occlusions)].</p> <p><em>Results:</em> Of 126 suspected stroke patients, there were 24 classic LVO and 34 extended LVO. For detection of classic LVO, the Hunter-8 had an AUC of 0.79 and the ACT-FAST had an AUC of 0.77. For extended LVO, the AUC was 0.71 and 0.70 respectively.</p> <p><em>Conclusion:</em> Both scales represent a significant opportunity to identify patients with proven potential benefit from thrombectomy (classic LVO), however M2 and basilar occlusions may be more challenging to identify with these scales.</p> 2022-03-22T00:00:00-07:00 Copyright (c) 2022 Cecilia Ostman, Carlos Garcia-Esperon, Thomas Lillicrap, Khaled Alanati, Beng Lim Alvin Chew, Jennifer Pedler, Sarah Edwards, Mark Parsons, Christopher Levi, Neil Spratt The Impact of the UK National Lockdown on Trauma Patterns and the Prehospital Advanced Trauma Team Response within Metropolitan London 2021-09-14T00:06:32-07:00 Andrew Milne Rory Saggers Tom Hurst Christine Henry Michael Christian <p><em>Introduction</em></p> <p>The societal changes triggered by the COVID-19 pandemic and resultant lockdowns have the potential to alter the incidence and nature of injuries within affected populations. We aimed to investigate these changes within Metropolitan London and the impact lockdown had on London’s Air Ambulance’s (LAA) response to incidents.</p> <p><em>Methods</em></p> <p>This retrospective cohort study compared data from all LAA missions in the two-month period following instigation of the 1st UK national lockdown in 2020 to the equivalent period in 2019. Patient demographics, nature and severity of injuries, incident details and LAA mission parameters were assessed.</p> <p><em>Results</em></p> <p>LAA saw a significant reduction in the mean (standard deviation) of activations per week under lockdown (32.75 [4.95] versus 54.25 [4.53], p&lt;0.001). The distribution of patients across different trauma aetiologies differed significantly under lockdown, with proportionately more injuries resulting from domestic violence (0.7% versus 3.8%) and deliberate self-harm (DSH [16.5% versus 12.4%]), although the absolute number of DSH fell. Significantly fewer incidents occurred in central areas of London, but injury severity was unaffected by lockdown. After adjustment for confounders, lockdown was associated with shorter drive times, but not overall response times. There was no association between lockdown and aetiology or severity of injuries.</p> <p><em>Conclusion</em></p> <p>The COVID-19 pandemic and ensuing UK national lockdown had a substantial impact on major trauma patterns within London and the subsequent LAA response. The feared rise in suicide was not observed, but there was a notable increase in domestic violence frequency.</p> 2022-03-22T00:00:00-07:00 Copyright (c) 2022 Andrew Milne, Rory Saggers, Tom P. Hurst, Christine L. Henry, Michael Christian Mentor or tormentor? A commentary on the fractured role of mentoring in paramedicine 2021-10-07T06:11:21-07:00 Andrew Bell Steve Whitfield <p>The relatively quick evolution of paramedicine and the inevitable ‘growing pains’ associated with an evolving profession has seen mentoring and the role of the mentor become clouded in confusion, ineffective education and a lack of specific research. Paramedicine’s recent development as a registered profession has also seen mentoring explicitly outlined as being a capability expected of all registered paramedics. However, the paramedic-mentoring model in Australia seems to have been mostly left up to the individual paramedic to develop in isolation from adequate training and mentoring themselves. If paramedicine is to continue its evolution as a legitimate healthcare profession, the quality of clinical mentoring must be acknowledged as a significant factor by higher education institutions, and the public and private services who employ paramedics, and nurtured accordingly.</p> 2021-10-10T00:00:00-07:00 Copyright (c) 2021 Andrew Bell, Steve Whitfield The nature of paramedic practice in rural and remote locations: A scoping review. 2021-10-15T00:11:05-07:00 Heulwen Spencer-Goodsir Judith Anderson Clare Sutton <p><strong>Introduction:</strong> Access to emergency healthcare services and specialist care – particularly paramedic services – is more restricted in the rural and remote areas of Australia, and this disparity is amplified further as remoteness increases. This review aims to investigate the availability of current research regarding both the expanding nature of paramedicine roles in rural environments, and the impacts of rurality on the quality of out-of-hospital care provided to patients.</p> <p><strong>Methods:</strong> Arksey and O’Malley’s six-step methodological approach was used to perform a scoping review to assess the availability of literature. Key words including paramedic*, regional, rural, remote and role were inputted into the search engines Scopus, CINAHL and PubMed. Titles and abstracts of the 864 results were screened by all authors and inclusion/exclusion criteria applied, resulting in 13 remaining articles.</p> <p><strong>Results:</strong> The final 13 articles comprised differing data collection types and methodologies from nine separate studies conducted in either Canada, Australia, the United Kingdom, the United States, Saudi Arabia or Qatar. Approximately 2.5 million patients, 534 paramedics, 331 other healthcare professionals and 35 case studies were included in the total combined results of these studies.</p> <p><strong>Conclusion:</strong> Rural communities demonstrated increased mortality rates in out-of-hospital patients due to several factors including rostering, specialist service locations and limited resource availability. Factors which were beneficial to the outcomes of patients in rural settings included enhanced paramedic scopes of practice, the implementation of community paramedicine programmes and wider roles within the community for paramedics. A lack of research on the exact nature of these changing roles in rural paramedicine is evident.</p> 2022-07-04T00:00:00-07:00 Copyright (c) 2022 Heulwen Spencer-Goodsir, Judith Anderson, Clare Sutton Potential overtreatment by paramedic students: A study from three South African higher education institutions 2022-03-31T21:32:11-07:00 Andrew William Makkink Emile Barnard <p><strong>Introduction:</strong> Healthcare students are often required to perform predetermined numbers of clinical skills to prove competence. The pressures of meeting predetermined clinical skill numbers may result in students overtreating patients. Overtreatment is not without consequence to the patient. This study aimed to investigate perceptions related to possible overtreatment of patients by emergency medical care students in three South African higher education institutions (HEIs).</p> <p><strong>Methods:</strong> This cross-sectional study used a purpose-designed, anonymous online questionnaire to collect data on possible patient overtreatment from emergency medical care student participants at three South African HEIs.</p> <p><strong>Results:</strong> Of the participants, 45 self-reported reasonably low incidences of overtreatment of patients. The prescribed skill requirements were deemed appropriate as were practical shift numbers, but there was concern about achieving prescribed skill numbers. Participants generally considered risk versus benefit and clinical mentors generally agreed with student decisions without permitting overtreatment practices. Intravenous (IV) cannulation, oxygen administration and spinal immobilisation were the most common forms of overtreatment with advanced airway management and IV cannulation the most difficult to achieve. Lack of appropriately qualified practitioners and low patient numbers were the most common barriers to achieving required skill numbers.</p> <p><strong>Conclusion:</strong> There was concern among participants about not reaching prerequisite skill numbers. Self-reported overtreatment of patients by participants was uncommon. The list of self-reported procedures most often forming part of overtreatment seemed to contradict this. The most common forms of overtreatment were clinical procedures that posed potential risk to the patient. There is a need to further explore overtreatment within healthcare student populations.</p> 2022-06-15T00:00:00-07:00 Copyright (c) 2022 Andrew William Makkink, Emile Barnard