How confident are Queensland paramedics with seizure recognition, differentiation, and management? A pilot study.

Abstract

Background: Paramedics in Australia present as the opportune medical personnel to initiate medical intervention of seizure presentations and perform a fundamental role in the prevention of seizure associated morbidity and mortality. Despite being well equipped to manage seizures, no literature exists regarding their confidence to recognise, differentiate, or manage seizures.

Methods: An online cross-sectional survey was undertaken by 168 paramedics practicing clinically for the Queensland Ambulance Service in Australia. The survey assessed paramedic perceived self-confidence surrounding seizure presentations. Non-parametric Kruskal-Wallis H-Test and post hoc pairwise comparisons were conducted to assess between group differences in relation to practicing qualifications, and years of service.

Results: Paramedics were confident in generalised convulsive seizure recognition and management, however, displayed less confidence surrounding non-convulsive, focal, and psychogenic seizure classifications. Critical care paramedics reported higher confidence than advanced care and graduate paramedics across various seizure presentation elements (p < 0.05). Paramedics with greater than 10 years of service reported higher confidence than those with fewer years of service, particularly less than two years.

Conclusion: Future education and professional development opportunities for paramedics require a greater focus on the development of self-confidence, with mechanisms implemented to increase paramedics' exposure to the broad spectrum of seizure presentations.