https://ajp.paramedics.org/index.php/ajp/issue/feed Australasian Journal of Paramedicine 2022-04-05T00:10:11-07:00 Amy Hutchison ajp@paramedics.org 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> https://ajp.paramedics.org/index.php/ajp/article/view/1032 A new era of opportunity – securing excellence for our Journal 2022-04-05T00:10:11-07:00 Paul Simpson paul.simpson@paramedics.org <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 https://ajp.paramedics.org/index.php/ajp/article/view/992 Australasian College of Paramedicine Student Conference (StuCon 2021) Abstracts - Oral and Poster Presentations 2021-08-03T00:10:08-07:00 Liam Bruton student.chair@paramedics.org <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 https://ajp.paramedics.org/index.php/ajp/article/view/989 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 cecilia.ostman@health.nsw.gov.au Carlos Garcia-Esperon carlos.garciaesperon@health.nsw.gov.au Thomas Lillicrap tom.lillicrap@newcastle.edu.au Khaled Alanati khaled.alanati@health.nsw.gov.au Beng Lim Alvin Chew benglim.chew@health.nsw.gov.au Jennifer Pedler jennifer.pedler@health.nsw.gov.au Sarah Edwards sarah.edwards1@health.nsw.gov.au Mark Parsons mark.parsons@health.nsw.gov.au Christopher Levi christopher.levi@health.nsw.gov.au Neil Spratt neil.spratt@health.nsw.gov.au <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 https://ajp.paramedics.org/index.php/ajp/article/view/985 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 andrew.milne@doctors.org.uk Rory Saggers rory.saggers@nhs.net Tom Hurst thomas.hurst2@nhs.net Christine Henry christine.henry6@nhs.net Michael Christian M.Christian@londonsairambulance.org.uk <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 https://ajp.paramedics.org/index.php/ajp/article/view/984 Mentor or tormentor? A commentary on the fractured role of mentoring in paramedicine 2021-10-07T06:11:21-07:00 Andrew Bell andrew.bell@usq.edu.au Steve Whitfield s.whitfield@griffith.edu.au <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 https://ajp.paramedics.org/index.php/ajp/article/view/976 Describing a 12-hour ambulance shift during a second wave of COVID-19 in London 2021-09-14T00:15:28-07:00 Alexandra Rengers ali.rengers@griffithuni.edu.au Emma Day emmylouday@gmail.com Steve Whitfield stevewhitfield4@gmail.com <p>The coronavirus disease (COVID-19), caused by the virus SARS-CoV-2, has strained international healthcare systems, including ambulance availability. Ambulance officers and paramedics are at the frontline of this pandemic and are therefore particularly exposed. Under normal operational circumstances, ambulance delivery is challenging; the effects of COVID-19 have exacerbated both the delivery of services and the stress placed on paramedics.</p> <p>In this case report, we describe a 12-hour emergency ambulance dayshift in central London during the second wave city-wide lockdown. We also discuss the impact COVID-19 has on day-to-day operations and the strategies employed to reduce paramedic infection.</p> 2021-09-26T00:00:00-07:00 Copyright (c) 2021 Alexandra Rengers, Emma Day, Steve Whitfield https://ajp.paramedics.org/index.php/ajp/article/view/975 Motivating factors influencing student paramedic choice of paramedicine as a career 2021-07-15T16:29:04-07:00 Anthony Weber a.weber2@cqu.edu.au Shannon Delport s.delport@cqu.edu.au Andrew Hodgetts a.hodgetts@cqu.edu.au <h3>Introduction</h3> <p>This study aimed to identify and assess the factors, motivations and influences on undergraduate students’ choice of paramedicine for their studies and ultimately a career in paramedicine.</p> <h3>Methods</h3> <p>A survey was available to 205 first-year Bachelor of Paramedic Science students to assess background, motivational factors and influences on choosing their undergraduate studies.</p> <h3>Results</h3> <p>The response rate to an online survey distributed to 205 students yielded an almost 25% response rate (n=51). Altruistic factors were the main reason students chose to study for a degree in paramedic science and ultimately a career in paramedicine. Although essential, extrinsic, sociodemographic and interpersonal factors were less motivating factors. Despite other research suggesting media coverage leads to increased student enrolments, the media coverage of paramedics as frontline health professionals during the COVID-19 pandemic and the ‘lights and sirens’ effect of ambulance/paramedic reality television shows as influences were not highly regarded.</p> <h3>Conclusion</h3> <p>The altruistic factors influencing career choices in paramedicine are generally similar across the healthcare industry. In this review, the motivating nature of extrinsic, interpersonal and sociodemographic factors was generally inconclusive. However, these factors may well apply to a university’s initial recruitment strategy and as a factor for ambulance services to consider when identifying the motivating factor of a student paramedic to join the workforce.</p> 2021-09-30T00:00:00-07:00 Copyright (c) 2021 Anthony Weber, Shannon Delport, Andrew Hodgetts https://ajp.paramedics.org/index.php/ajp/article/view/965 Time Management Attitudes of Health Care Workers Employed in the Ambulance Service in Turkey 2021-10-12T05:28:12-07:00 Ismet Celebi ismetcelebi17@hotmail.com Gülbahar Alkaş baharalkas@hotmail.com <p><strong>Introduction: </strong>Health care workers employed in the ambulance service should minimize their response time when responding to a medical emergency. Prehospital emergency medical services operate on a 24-h basis; hence, time management in both the work and social lives of the staff is more difficult than in other occupational groups. In the case of emergency health services, time management is no doubt the most important aspect in terms of human health. The purpose of this research was to examine the time management skills and influencing factors of health care workers employed in the ambulance service.</p> <p><strong>Methods: </strong>In this cross-sectional study, a questionnaire containing time management inventory (TMI) and demographics was applied. In the analysis of the data, the number, chi square, percentage, and t test were applied using SPSS statistical software.</p> <p><strong>Results: </strong>Of those who participated in the survey, 57.8% were male, 86.2% were working at the emergency medical service station, and 49.9% were paramedics. The average TMI was 70.49. In the time-consumption subdimension of the survey, when the genders of the health care workers who were employed in the ambulance service were compared, there was a statistically significant difference according to education status for the total time management.</p> <p><strong>Conclusion: </strong>In this study, it was determined that the male health care workers who were employed in the ambulance service were better able to manage their time when compared to the females, and they had better time management skills than the high school graduates.</p> 2022-04-26T00:00:00-07:00 Copyright (c) 2022 Ismet Celebi, Gülbahar Alkaş https://ajp.paramedics.org/index.php/ajp/article/view/963 Perceptions and Knowledge of Self-Regulation of Paramedics in Australia 2021-10-12T05:17:55-07:00 Buck Reed b.reed@westernsydney.edu.au Leanne Cowin l.cowin@westernsydney.edu.au Peter O'Meara peter.omeara@monash.edu Ian Wilson ianwil@uow.edu.au <p><strong>Introduction</strong></p> <p>Since 2018, paramedics in Australia have been self-regulated under the National Registration and Accreditation Scheme (NRAS) for health professionals. While paramedics and other health practitioners are self-regulated in many jurisdictions internationally, there has been little study of the impact on practitioners of the introduction of new regulatory frameworks.</p> <p><strong>Method</strong></p> <p>Paramedics undertook a survey in the month leading up the commencement of self-regulation collecting both qualitative and quantitative data. The survey was completed by 419 participants. This paper explores the analysis of quantitative data. Key results were cross-tabulated with demographic factors.</p> <p><strong> </strong><strong>Results</strong></p> <p>Participants indicated they had good broad knowledge of the regulatory scheme but were less confident on more detailed aspects. Most believed that patient safety and practitioner accountability will improve with registration however results were less clear on changes in scope, remuneration or employment opportunities. Questions on identity indicated that the primary factors in paramedic identity construction were employment status, qualifications and scope with impending registration the least important factor. Overall, 59% of participants supported self-regulation, however 25% indicated they held negative views. When cross-tabulated with demographics, years of service and initial qualification (vocational vs university) showed relationships with support for regulation.</p> <p><strong>Conclusion</strong></p> <p>The introduction of self-regulation represents significant change to both the governance of paramedics and entry to the profession. Uncertainty By some is indicative of the unique nature and impact of the change. However, there is wide agreement that the scheme will increase safety and accountability which are the key aims of professional regulation.</p> 2021-12-16T00:00:00-08:00 Copyright (c) 2021 Buck Reed, Leanne Cowin, Peter O'Meara, Ian Wilson https://ajp.paramedics.org/index.php/ajp/article/view/959 The demographic and clinical practice profile of Australian remote and industrial paramedics: Findings from a workforce survey 2021-06-20T06:25:10-07:00 Joseph James Acker jjacker@me.com Tania Johnston tjohnston@csu.edu.au <p><strong>Introduction</strong><br />A large workforce is employed in remote environments in the Australian mining and fuel sectors. Whereas paramedics are increasingly assuming roles as healthcare providers in these locations, little is known about industrial paramedic practice. The aim of this exploratory study was to better understand the demographics, education, clinical practice and work environment of the Australian paramedic workforce in remote and industrial settings to inform future research and education for the emerging specialty.</p> <p><strong>Methods</strong> <br />Web-based respondent driven network sampling was used to recruit remote and industrial paramedics in this cross-sectional descriptive study. A self-administered questionnaire elicited responses (n=111) about participant demographics, work environment, initial and continuing education, and clinical scope of practice.</p> <p><strong>Results</strong><br />Paramedic participants working in remote and industrial settings are predominately male (86.5%) with the majority aged 35 to 44 years (38.7%). Their job titles range widely and include paramedic, intensive care paramedic, industrial, mine and offshore paramedics. Participants report an average of 15.4 years of total healthcare experience and working in the remote or industrial health sector for a mean of 7.1 years, primarily in Western Australia (34.2%). These paramedics often engage in continuing education, with 45% studying at a vocational or tertiary institution at the time of the survey. Most respondents (63.9%) describe their employment as directly or indirectly related to the natural resource sector and 75.7% have experience in remote settings such as camps, mining sites, offshore platforms, vessels or small communities. Most practitioners (59.5%) work in a full-time capacity and can perform core paramedic skills including intravenous cannulation, 12-lead electrocardiogram interpretation, chest needle decompression and restricted drug administration. Additionally, more than 40% of those actively working in the sector report having endotracheal intubation and intraosseous access in their scope of practice. They also administer immunisations, antibiotics and other prescription medications, manage chronic diseases, and perform low acuity skills typically included in a community paramedic role.</p> <p><strong>Conclusion</strong><br />This workforce survey is the first of its kind designed to gain a broader understanding of the paramedic practitioners who work in remote and industrial settings and the characteristics of their work environment. Key areas highlighted by this study serve to inform professional regulators, educators and employers with respect to the skills that remote and industrial paramedics perform and the education that is required to support the evolving specialised practice.</p> 2021-08-18T00:00:00-07:00 Copyright (c) 2021 Joseph James Acker, Ms Tania Johnston