Pub Date : 2025-08-18DOI: 10.1016/j.auec.2025.08.001
Qiqi Liu , Lijin Zhou , Yuanyuan Tang , Wenlin Cheng , Yifan Zhang , Yanjie Ma , Yanhong Liu , Rui Li
Objective
This study aimed to explore the in-service training needs and expectations of junior nurses in Chinese emergency departments, using the Capability-Opportunity-Motivation-Behaviour (COM-B) model to inform the development of targeted training strategies.
Methods
A qualitative descriptive design and inductive thematic analysis were used. Semi-structured face-to-face interviews were conducted with 16 emergency department (ED) staff between January and February 2025.
Results
The training needs and expectations of junior ED nurses can be summarised into four themes: capability, the depth of mental and physical needs; opportunity, the two-way construction of physical and social opportunities; motivation, the synergy of self-motivation and reflective motivation; and training management: diversified training forms, scientifically reasonable training time, composite team of lecturers, and multidimensional assessment and evaluation.
Conclusion
In developing in-service training program, nursing managers should pay attention to the needs of nurses in terms of competence, motivation, opportunity and training management, and design training content and forms that meet actual needs, in order to enhance the professionalism and clinical competence of junior ED nurses, strengthen professional identity and work motivation, reduce the willingness to leave, and promote sustainable development.
{"title":"In-service training needs and expectations of junior nurses in Chinese emergency departments: A qualitative study based on the COM-B model","authors":"Qiqi Liu , Lijin Zhou , Yuanyuan Tang , Wenlin Cheng , Yifan Zhang , Yanjie Ma , Yanhong Liu , Rui Li","doi":"10.1016/j.auec.2025.08.001","DOIUrl":"10.1016/j.auec.2025.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to explore the in-service training needs and expectations of junior nurses in Chinese emergency departments, using the Capability-Opportunity-Motivation-Behaviour (COM-B) model to inform the development of targeted training strategies.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design and inductive thematic analysis were used. Semi-structured face-to-face interviews were conducted with 16 emergency department (ED) staff between January and February 2025.</div></div><div><h3>Results</h3><div>The training needs and expectations of junior ED nurses can be summarised into four themes: capability, the depth of mental and physical needs; opportunity, the two-way construction of physical and social opportunities; motivation, the synergy of self-motivation and reflective motivation; and training management: diversified training forms, scientifically reasonable training time, composite team of lecturers, and multidimensional assessment and evaluation.</div></div><div><h3>Conclusion</h3><div>In developing in-service training program, nursing managers should pay attention to the needs of nurses in terms of competence, motivation, opportunity and training management, and design training content and forms that meet actual needs, in order to enhance the professionalism and clinical competence of junior ED nurses, strengthen professional identity and work motivation, reduce the willingness to leave, and promote sustainable development.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 36-44"},"PeriodicalIF":2.1,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-15DOI: 10.1016/j.auec.2025.08.002
Alys-Marie Manguy , Ed Oakley , Rob Gordon , Lynette Joubert
Background
Family presence during critical paediatric emergencies is increasingly accepted practice in paediatric emergency departments, within Australia and internationally. However, limited research explores parent experiences in high-acuity, resuscitation-level presentations.
Methods
This qualitative study used Attride-Stirling’s thematic network analysis methodology to identify key themes. Semi-structured telephone interviews were undertaken with 20 parents whose child received care during a critical paediatric emergency at the Emergency Department of The Royal Children’s Hospital, Melbourne, Australia.
Results
Thematic network analysis identified 136 unique themes relating to parent experiences and self-identified psychosocial care needs, resulting in the two organising themes of ‘Parent perspectives’ and ‘Emergency system interventions’, and the global theme of ‘Family responsive service protocols’. These findings highlight the value of family-centred care approaches in paediatric emergency settings, emphasising the importance of staff communication skills and peri-event psychosocial support throughout the episode of care.
Conclusions
Recommendations for practice include enhancing communication strategies, improving pre-arrival preparation, optimising the physical environment, and implementing dedicated family support roles.
{"title":"Parent experiences and psychosocial needs during critical paediatric emergencies: A thematic network analysis","authors":"Alys-Marie Manguy , Ed Oakley , Rob Gordon , Lynette Joubert","doi":"10.1016/j.auec.2025.08.002","DOIUrl":"10.1016/j.auec.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Family presence during critical paediatric emergencies is increasingly accepted practice in paediatric emergency departments, within Australia and internationally. However, limited research explores parent experiences in high-acuity, resuscitation-level presentations.</div></div><div><h3>Methods</h3><div>This qualitative study used Attride-Stirling’s thematic network analysis methodology to identify key themes. Semi-structured telephone interviews were undertaken with 20 parents whose child received care during a critical paediatric emergency at the Emergency Department of The Royal Children’s Hospital, Melbourne, Australia.</div></div><div><h3>Results</h3><div>Thematic network analysis identified 136 unique themes relating to parent experiences and self-identified psychosocial care needs, resulting in the two organising themes of ‘Parent perspectives’ and ‘Emergency system interventions’, and the global theme of ‘Family responsive service protocols’. These findings highlight the value of family-centred care approaches in paediatric emergency settings, emphasising the importance of staff communication skills and peri-event psychosocial support throughout the episode of care.</div></div><div><h3>Conclusions</h3><div>Recommendations for practice include enhancing communication strategies, improving pre-arrival preparation, optimising the physical environment, and implementing dedicated family support roles.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 45-53"},"PeriodicalIF":2.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-07DOI: 10.1016/j.auec.2025.07.002
Rachael Middleton, Tanya Capper, Robbie King, Scott Devenish
Over the past decade, health care and ambulance organisations worldwide have reported increasing paramedic attrition rates, with many of these leavers exiting the profession entirely. Retaining experienced paramedics is necessary to improve patient outcomes, decreasing onboarding costs, and to continue the progression of the profession. Understanding paramedic attrition has gained more interest in the literature; however, studies have mainly focussed on paramedics leaving their place of employment rather than the profession altogether. It is important that this distinction is made as the influencing factors likely vary, requiring different retention strategies. This scoping review aimed to determine the main factors influencing paramedics to leave the profession and identify areas for further research. A total of 1026 articles were screened, of which 28 were included in the final review. Content analysis of their key findings led to the identification of three main themes and 14 subthemes that illustrate the main factors influencing paramedics’ decisions to leave the profession. This review found that paramedic attrition is driven by a complex combination of organisational, occupational, and personal factors. More research, especially from outside the United States, is needed to better understand why paramedics are leaving the profession and to identify targeted retention strategies.
{"title":"Understanding paramedic attrition: A scoping review exploring why paramedics are leaving the profession","authors":"Rachael Middleton, Tanya Capper, Robbie King, Scott Devenish","doi":"10.1016/j.auec.2025.07.002","DOIUrl":"10.1016/j.auec.2025.07.002","url":null,"abstract":"<div><div>Over the past decade, health care and ambulance organisations worldwide have reported increasing paramedic attrition rates, with many of these leavers exiting the profession entirely. Retaining experienced paramedics is necessary to improve patient outcomes, decreasing onboarding costs, and to continue the progression of the profession. Understanding paramedic attrition has gained more interest in the literature; however, studies have mainly focussed on paramedics leaving their place of employment rather than the profession altogether. It is important that this distinction is made as the influencing factors likely vary, requiring different retention strategies. This scoping review aimed to determine the main factors influencing paramedics to leave the profession and identify areas for further research. A total of 1026 articles were screened, of which 28 were included in the final review. Content analysis of their key findings led to the identification of three main themes and 14 subthemes that illustrate the main factors influencing paramedics’ decisions to leave the profession. This review found that paramedic attrition is driven by a complex combination of organisational, occupational, and personal factors. More research, especially from outside the United States, is needed to better understand why paramedics are leaving the profession and to identify targeted retention strategies.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 22-29"},"PeriodicalIF":2.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05DOI: 10.1016/j.auec.2025.07.003
Saartje Berendsen Russell , Shanti Pun , Farina Jeyaraj , Margaret Murphy , Nicole Bohlken , Emma Jenkins , Kerrie Bubb , Naomi Derrick , William Royle , Radhika Seimon , Kendall Bein , Michael M. Dinh
Background
Adolescents with mental health concerns are increasingly presenting to emergency departments (EDs). Understanding psychosocial triggers that contribute to presentation may improve patient management. This study aimed to identify these psychosocial factors using the HEEADSSS assessment framework for adolescents. HEEADSSS is an acronym for the topics it incorporates; Home; Education/Employment; Eating/Exercise (Sleep); Activities/Peer Relationships (Hobbies); Drug use; Sexuality (Sexual orientation/Gender); Suicide (Self-harm/Depression/ Mood); Safety and Spirituality.
Methods
This was a retrospective chart review of electronic medical records (eMR) of mental health presentations in 10–24-year-olds to three metropolitan EDs during 2021. Trained nurses collected data from the ED clinical notes. De-identified data were categorically indexed to the topics of the HEEADSSS framework and analysed qualitatively to identify psychosocial factors and themes relating to MH presentation.
Results
1748 presentations were analysed. The categories of Home, Mood, Sleep, Suicide and Peer Relationships identified high rates of issues amongst the study population. Common issues included difficult family dynamics (30.0 %), trauma (26.4 %), low mood (30.3 %), poor sleep (30.8 %) as well as themes of loneliness (7.6 %) and feeling socially isolated (18.2 %).
Conclusion
Using the HEEADSSS assessment framework allowed capture of unique psychosocial factors that contributed to mental health concerns for adolescents presenting to ED. Further research is needed to determine the importance of each factor as a precipitating reason for ED presentation.
{"title":"Psychosocial factors associated with mental health presentations of adolescents to the emergency department in Sydney, Australia: A retrospective review","authors":"Saartje Berendsen Russell , Shanti Pun , Farina Jeyaraj , Margaret Murphy , Nicole Bohlken , Emma Jenkins , Kerrie Bubb , Naomi Derrick , William Royle , Radhika Seimon , Kendall Bein , Michael M. Dinh","doi":"10.1016/j.auec.2025.07.003","DOIUrl":"10.1016/j.auec.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with mental health concerns are increasingly presenting to emergency departments (EDs). Understanding psychosocial triggers that contribute to presentation may improve patient management. This study aimed to identify these psychosocial factors using the HEEADSSS assessment framework for adolescents. HEEADSSS is an acronym for the topics it incorporates; Home; Education/Employment; Eating/Exercise (Sleep); Activities/Peer Relationships (Hobbies); Drug use; Sexuality (Sexual orientation/Gender); Suicide (Self-harm/Depression/ Mood); Safety and Spirituality.</div></div><div><h3>Methods</h3><div>This was a retrospective chart review of electronic medical records (eMR) of mental health presentations in 10–24-year-olds to three metropolitan EDs during 2021. Trained nurses collected data from the ED clinical notes. De-identified data were categorically indexed to the topics of the HEEADSSS framework and analysed qualitatively to identify psychosocial factors and themes relating to MH presentation.</div></div><div><h3>Results</h3><div>1748 presentations were analysed. The categories of Home, Mood, Sleep, Suicide and Peer Relationships identified high rates of issues amongst the study population. Common issues included difficult family dynamics (30.0 %), trauma (26.4 %), low mood (30.3 %), poor sleep (30.8 %) as well as themes of loneliness (7.6 %) and feeling socially isolated (18.2 %).</div></div><div><h3>Conclusion</h3><div>Using the HEEADSSS assessment framework allowed capture of unique psychosocial factors that contributed to mental health concerns for adolescents presenting to ED. Further research is needed to determine the importance of each factor as a precipitating reason for ED presentation.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 30-35"},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-28DOI: 10.1016/j.auec.2025.07.001
Anna O’Hare , Geoffrey Melville , Brenton Ritchie , Ryan Kloger , Barb Crawford , Kate Curtis
Background
Australia has a nursing shortage. Emergency Departments (EDs) are particularly affected, necessitating interventions to support and retain new emergency nurses. This study evaluates "In from the Beginning," a framework designed to improve the experience of new emergency nurses.
Methods
A 12-month longitudinal study was conducted in 2023–2024 at three Australian EDs with 72 nurses. Surveys administered at baseline, six and 12 months were used to assess ascent to competence and belonging. Differences between groups were assessed using nonparametric tests, changes over time with linear mixed-effects models and content analysis for free text.
Results
All 72 nurses participated, 15 received the intervention, 50 (70 %) completed 12 m follow-up. Participants reported high levels of feeling welcomed (median 26.5/30). The intervention group reported lower baseline self-confidence, but greater rate of improvement compared to control group (β=8.95, SE=3.75, p = 0.019). There were no differences in belonging, learning and competency. Qualitative data emphasised importance of mentorship. Retention at 12 months was 87 % in the intervention group and 65 % in control group (Χ2(1) = 1.72. p = 0.19).
Conclusion
The "In from the Beginning" framework provided support to new emergency nurses and resulted in improved self-confidence. Future research will explore long-term impacts on retention.
{"title":"“In from the Beginning” – Evaluation of a framework to improve the experience of nurses commencing in the emergency department","authors":"Anna O’Hare , Geoffrey Melville , Brenton Ritchie , Ryan Kloger , Barb Crawford , Kate Curtis","doi":"10.1016/j.auec.2025.07.001","DOIUrl":"10.1016/j.auec.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Australia has a nursing shortage. Emergency Departments (EDs) are particularly affected, necessitating interventions to support and retain new emergency nurses. This study evaluates \"In from the Beginning,\" a framework designed to improve the experience of new emergency nurses.</div></div><div><h3>Methods</h3><div>A 12-month longitudinal study was conducted in 2023–2024 at three Australian EDs with 72 nurses. Surveys administered at baseline, six and 12 months were used to assess ascent to competence and belonging. Differences between groups were assessed using nonparametric tests, changes over time with linear mixed-effects models and content analysis for free text.</div></div><div><h3>Results</h3><div>All 72 nurses participated, 15 received the intervention, 50 (70 %) completed 12 m follow-up. Participants reported high levels of feeling welcomed (median 26.5/30). The intervention group reported lower baseline self-confidence, but greater rate of improvement compared to control group (β=8.95, SE=3.75, p = 0.019). There were no differences in belonging, learning and competency. Qualitative data emphasised importance of mentorship. Retention at 12 months was 87 % in the intervention group and 65 % in control group (Χ<sup>2</sup><sub>(1)</sub> = 1.72. p = 0.19).</div></div><div><h3>Conclusion</h3><div>The \"In from the Beginning\" framework provided support to new emergency nurses and resulted in improved self-confidence. Future research will explore long-term impacts on retention.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 14-21"},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-15DOI: 10.1016/j.auec.2025.06.009
Samantha Ryan , Elizabeth Forster , Anna Sullivan , Natalie Phillips , Bronwyn Griffin
Aims
To identify, analyse, and synthesise retrospective data regarding the characteristics and risk factors that primary immune deficiencies (PIDs) inhibit to enhance patient outcomes and improve healthcare professional knowledge.
Background
There is currently limited research regarding the management of this high-risk paediatric cohort when they present to an emergency department (ED). This review analyses clinical data in the management, treatment and outcomes for these patients.
Design
This retrospective cohort review analysed patient characteristics, including the ED presentation and treatments, and hospital outcomes for children with a PID.
Method
Data from electronic medical records were extracted at a large tertiary paediatric hospital in South-East Queensland according to inclusion and exclusion criteria. Identified cases deidentified, analysed and reported. Baseline variables summarised using descriptive statistics.
Results
Out of 789 ED presentations relating either to fever or PID, 126 cases met the inclusion criteria. Overall, the length of time to be seen by a clinician in ED was a mean of 83 min, 27.8 % did not receive any treatment. Eleven patients had no investigations performed at all, of those who did, 5 % returned positive blood cultures. The immunology team were not consulted for 52 % of patients, and among those admitted, 70.3 % were classed as having a complex medical history.
Conclusions
There is limited consistency surrounding the management of children with a PID who present to the ED with a fever. Further research and resources are needed to facilitate enhanced emergency management to increase positive outcomes for this rare, but at-risk cohort of paediatric patients.
{"title":"A retrospective cohort review study of patients with a primary immune deficiency who have presented to the paediatric emergency department with a fever","authors":"Samantha Ryan , Elizabeth Forster , Anna Sullivan , Natalie Phillips , Bronwyn Griffin","doi":"10.1016/j.auec.2025.06.009","DOIUrl":"10.1016/j.auec.2025.06.009","url":null,"abstract":"<div><h3>Aims</h3><div>To identify, analyse, and synthesise retrospective data regarding the characteristics and risk factors that primary immune deficiencies (PIDs) inhibit to enhance patient outcomes and improve healthcare professional knowledge.</div></div><div><h3>Background</h3><div>There is currently limited research regarding the management of this high-risk paediatric cohort when they present to an emergency department (ED). This review analyses clinical data in the management, treatment and outcomes for these patients.</div></div><div><h3>Design</h3><div>This retrospective cohort review analysed patient characteristics, including the ED presentation and treatments, and hospital outcomes for children with a PID.</div></div><div><h3>Method</h3><div>Data from electronic medical records were extracted at a large tertiary paediatric hospital in South-East Queensland according to inclusion and exclusion criteria. Identified cases deidentified, analysed and reported. Baseline variables summarised using descriptive statistics.</div></div><div><h3>Results</h3><div>Out of 789 ED presentations relating either to fever or PID, 126 cases met the inclusion criteria. Overall, the length of time to be seen by a clinician in ED was a mean of 83 min, 27.8 % did not receive any treatment. Eleven patients had no investigations performed at all, of those who did, 5 % returned positive blood cultures. The immunology team were not consulted for 52 % of patients, and among those admitted, 70.3 % were classed as having a complex medical history.</div></div><div><h3>Conclusions</h3><div>There is limited consistency surrounding the management of children with a PID who present to the ED with a fever. Further research and resources are needed to facilitate enhanced emergency management to increase positive outcomes for this rare, but at-risk cohort of paediatric patients.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 328-333"},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.auec.2025.06.008
Rachael Vella , Amy Hutchison , Paul Simpson , Robin Pap
Introduction
Consensus-based studies are increasingly common in paramedicine research. Whilst there are four main consensus methodologies, recent analyses in other disciplines describe great diversity in method characterised by frequent modifications.
Aim
To describe the application and characteristics of consensus research methodologies in paramedicine.
Methods
A bibliographic analysis was conducted of published research reporting use of a consensus methodology, drawing data from MEDLINE, EMBASE, CINAHL. Two researchers performed abstract screening, full text review, and data extraction. A descriptive analysis was conducted.
Results
There were 161 paramedicine consensus studies published between 1997 and 2024. Delphi technique was most frequent (83 %), followed by NGT (12 %). The US accounted for the most studies with 44 (26 %), followed by UK with 33 (20 %), Canada 15 (9 %), Norway 12 (7 %) and Australia 12 (7 %). Modifications were reported by authors in 54 % of studies. Of 141 Delphi studies, 31 % demonstrated the use of published reporting or methodological guidance.
Conclusion
The prevalence of consensus research has increased considerably, dominated by Delphi methodology. Significant methodological heterogeneity was observed, and engagement with methodological and reporting guidelines appeared uncommon. There may be a need for stronger methodological guidance within the paramedicine research space to ensure quality in consensus research.
{"title":"The rise of consensus methods in paramedicine research: A bibliographic analysis","authors":"Rachael Vella , Amy Hutchison , Paul Simpson , Robin Pap","doi":"10.1016/j.auec.2025.06.008","DOIUrl":"10.1016/j.auec.2025.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Consensus-based studies are increasingly common in paramedicine research. Whilst there are four main consensus methodologies, recent analyses in other disciplines describe great diversity in method characterised by frequent modifications.</div></div><div><h3>Aim</h3><div>To describe the application and characteristics of consensus research methodologies in paramedicine.</div></div><div><h3>Methods</h3><div>A bibliographic analysis was conducted of published research reporting use of a consensus methodology, drawing data from MEDLINE, EMBASE, CINAHL. Two researchers performed abstract screening, full text review, and data extraction. A descriptive analysis was conducted.</div></div><div><h3>Results</h3><div>There were 161 paramedicine consensus studies published between 1997 and 2024. Delphi technique was most frequent (83 %), followed by NGT (12 %). The US accounted for the most studies with 44 (26 %), followed by UK with 33 (20 %), Canada 15 (9 %), Norway 12 (7 %) and Australia 12 (7 %). Modifications were reported by authors in 54 % of studies. Of 141 Delphi studies, 31 % demonstrated the use of published reporting or methodological guidance.</div></div><div><h3>Conclusion</h3><div>The prevalence of consensus research has increased considerably, dominated by Delphi methodology. Significant methodological heterogeneity was observed, and engagement with methodological and reporting guidelines appeared uncommon. There may be a need for stronger methodological guidance within the paramedicine research space to ensure quality in consensus research.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 322-327"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.auec.2025.06.007
Camilla Dannvall , Hilda Öhman , Johan Herlitz , Magnus Andersson Hagiwara , Carl Magnusson
Background
Abdominal pain is a common symptom encountered by emergency medical services (EMS) in Sweden. EMS nurses follow a structured process involving clinical history, physical examination, and final assessment, as guided by regional protocols. However, little is known about EMS nurses' adherence to these guidelines.
Objective
This study aims to evaluate adherence to regional guidelines for managing abdominal pain in EMS and explore whether EMS nurses' educational level is associated with adherence.
Methods
A retrospective, descriptive review of EMS case records for patients with ESS Code 6 (abdominal pain) was conducted. Data were analyzed to compare adherence to guidelines between EMS nurses with and without specialized education.
Results
A total of 600 cases were reviewed. Guideline adherence was suboptimal in several areas, such as pain intensity documented in only 36 % of cases, and abdominal palpation performed in 70 %. EMS nurses with specialized education were more likely to administer pain relief, perform abdominal palpation, and measure blood glucose.
Conclusion
Adherence to guidelines for managing abdominal pain in EMS was limited, particularly in documenting pain intensity. The findings suggest that a higher level of education among EMS nurses may improve compliance with assessment and treatment protocols.
{"title":"Prehospital nurse adherence to abdominal pain guidelines in Sweden and possible association with educational level","authors":"Camilla Dannvall , Hilda Öhman , Johan Herlitz , Magnus Andersson Hagiwara , Carl Magnusson","doi":"10.1016/j.auec.2025.06.007","DOIUrl":"10.1016/j.auec.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Abdominal pain is a common symptom encountered by emergency medical services (EMS) in Sweden. EMS nurses follow a structured process involving clinical history, physical examination, and final assessment, as guided by regional protocols. However, little is known about EMS nurses' adherence to these guidelines.</div></div><div><h3>Objective</h3><div>This study aims to evaluate adherence to regional guidelines for managing abdominal pain in EMS and explore whether EMS nurses' educational level is associated with adherence.</div></div><div><h3>Methods</h3><div>A retrospective, descriptive review of EMS case records for patients with ESS Code 6 (abdominal pain) was conducted. Data were analyzed to compare adherence to guidelines between EMS nurses with and without specialized education.</div></div><div><h3>Results</h3><div>A total of 600 cases were reviewed. Guideline adherence was suboptimal in several areas, such as pain intensity documented in only 36 % of cases, and abdominal palpation performed in 70 %. EMS nurses with specialized education were more likely to administer pain relief, perform abdominal palpation, and measure blood glucose.</div></div><div><h3>Conclusion</h3><div>Adherence to guidelines for managing abdominal pain in EMS was limited, particularly in documenting pain intensity. The findings suggest that a higher level of education among EMS nurses may improve compliance with assessment and treatment protocols.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"28 4","pages":"Pages 314-321"},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.auec.2025.06.010
Ashlea Smith BSc , David Majewski PhD , Gavin Pereira PhD , Jason Belcher MPhil , Karen Stewart , Judith Finn PhD , Stephen Ball PhD
Background
Internationally, rural areas tend to have prolonged emergency medical service (EMS) response times, associated with a lower survival from out-of-hospital cardiac arrest (OHCA). We examined how the components of EMS response time to OHCA vary according to rurality in Western Australia (WA), and estimated the effect that reducing rural mobilisation times might have on OHCA survival.
Methods
Using a retrospective cohort of medical OHCAs in WA with EMS-resuscitation attempted, from 2015 to 2022, we compared the components of response time (Triage, Mobilisation, Travel to the scene and Total Response), stratified by regional remoteness and proximity to nearest town. Using only the rural subgroup, we then used counterfactual simulation methodology to estimate the number of 30-day survivors if response times were reduced in rural areas.
Results
Total EMS response time increased with increasing regional remoteness. Mobilisation time also increased with regional remoteness, even among OHCAs occurring within towns; in rural areas, median mobilisation time was 3.32 mins (1.43, 10.00) (mean 6.24, sd 6.61), with metropolitan areas having a median of 0.97 mins (0.63, 1.48) (mean 1.43, sd 2.65). If rural areas had the same mean mobilisation time as metropolitan areas, the relative increase in the estimated number of rural survivors (16.9 %) was not statistically significant.
Conclusion
Mobilisation times were significantly longer in rural areas of WA than metropolitan. These results demonstrate that the effects of rurality on OHCA response time are not simply due to rural patients having increased distance from emergency services. Efforts to improve rapid bystander interventions may be particularly beneficial in rural towns for the crucial minutes before EMS personnel arrive.
{"title":"So close, yet so far: Understanding the relationship between ambulance mobilisation times and survival from out-of-hospital cardiac arrest in rural Western Australia","authors":"Ashlea Smith BSc , David Majewski PhD , Gavin Pereira PhD , Jason Belcher MPhil , Karen Stewart , Judith Finn PhD , Stephen Ball PhD","doi":"10.1016/j.auec.2025.06.010","DOIUrl":"10.1016/j.auec.2025.06.010","url":null,"abstract":"<div><h3>Background</h3><div>Internationally, rural areas tend to have prolonged emergency medical service (EMS) response times, associated with a lower survival from out-of-hospital cardiac arrest (OHCA). We examined how the components of EMS response time to OHCA vary according to rurality in Western Australia (WA), and estimated the effect that reducing rural mobilisation times might have on OHCA survival.</div></div><div><h3>Methods</h3><div>Using a retrospective cohort of medical OHCAs in WA with EMS-resuscitation attempted, from 2015 to 2022, we compared the components of response time (Triage, Mobilisation, Travel to the scene and Total Response), stratified by regional remoteness and proximity to nearest town. Using only the rural subgroup, we then used counterfactual simulation methodology to estimate the number of 30-day survivors if response times were reduced in rural areas.</div></div><div><h3>Results</h3><div>Total EMS response time increased with increasing regional remoteness. Mobilisation time also increased with regional remoteness, even among OHCAs occurring within towns; in rural areas, median mobilisation time was 3.32 mins (1.43, 10.00) (mean 6.24, sd 6.61), with metropolitan areas having a median of 0.97 mins (0.63, 1.48) (mean 1.43, sd 2.65). If rural areas had the same mean mobilisation time as metropolitan areas, the relative increase in the estimated number of rural survivors (16.9 %) was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Mobilisation times were significantly longer in rural areas of WA than metropolitan. These results demonstrate that the effects of rurality on OHCA response time are not simply due to rural patients having increased distance from emergency services. Efforts to improve rapid bystander interventions may be particularly beneficial in rural towns for the crucial minutes before EMS personnel arrive.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"29 1","pages":"Pages 4-13"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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