Paramedics Take Heat from Emergency Departments

Author:  Metcalfe David
Date:  October 2007

To some they are just ambulance drivers,' but some paramedics in the UK have demonstrated their worth by treating patients without taking them to hospital. According to one study published in the British Medical Journal earlier this month, paramedics can provide an effective alternative to taking patients directly to hospital. The work was led by Dr Suzanne Mason, a reader in emergency medicine at the University of Sheffield, and concluded that paramedics may be trained to provide a viable alternative "to standard ambulance transfer and treatment in an emergency department for elderly patients with acute minor conditions."

Researchers selected seven paramedics on completion of the Paramedic Practitioner in Older People's Support course. These paramedics were tasked with providing help at home to elderly patients seeking help for non-life threatening conditions after such calls were identified by the ambulance control room. Patients in the group treated in this manner were 25 percent less likely to attend hospital than those seen by paramedics working for the standard ambulance service. Furthermore, patients treated under the new system were more likely to express satisfaction with their level of care. There were no statistically significant differences in mortality or morbidity between the two groups.

The system was evaluated by monitoring emergency room attendance and by asking patients to complete a postal questionnaire at three and 28 days post-treatment.

In addition, this study shows that randomized controlled trials can be conducted to determine whether changes to local ambulance services are feasible. According to an editorial that accompanied this paper, "the trial shows that high quality study designs are feasible in this setting. Such trials should, therefore, be used to evaluate the more widespread emergency care practitioner scheme and other extended scope paramedic programmes before further costly expansions take place."

Written by David Metcalfe

Reviewed by Elizabeth Ng

Published by Pooja Ghatalia.