Australasian Emergency Care最新文献

{"title":"Establishing enablers and barriers to implementing the HIRAID® emergency nursing framework in rural emergency departments","authors":"Belinda Kennedy ,&nbsp;Kate Curtis ,&nbsp;Sarah Kourouche ,&nbsp;Louise Casey ,&nbsp;Dorothy Hughes ,&nbsp;Vivienne Chapman ,&nbsp;Margaret Fry","doi":"10.1016/j.auec.2024.08.002","DOIUrl":"10.1016/j.auec.2024.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Rural Australia has large geographic distances between emergency departments with variability of services and medical support. Emergency nurses must be appropriately skilled to assess and manage unpredictable and diverse presentations. HIRAID® is an evidence-based framework to support emergency nurses in assessment and care delivery. To inform implementation, the study aimed to identify the enablers and barriers to introducing HIRAID® in practice.</div></div><div><h3>Methods</h3><div>This embedded mixed methods study was conducted in 11 rural, regional emergency departments in Southern New South Wales, Australia. Respondents completed a 22-item survey, indicating their level of agreement on statements related to practice change, free text responses were optional. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Results were identified as barriers or enablers, then integrated and mapped to the Theoretical Domains Framework.</div></div><div><h3>Results</h3><div>The survey was completed by 102 (54 %) nurses. Two enablers and four barriers to implementation were identified and mapped to 10 Theoretical Domains Framework domains. Key barriers were workplace limitations, such as time and resources, and knowledge of the HIRAID® intervention.</div></div><div><h3>Conclusion</h3><div>Barriers varied between facilities related to adequate support to implement and the impact on patient care. The results will inform a strategy to implement HIRAID®.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 290-298"},"PeriodicalIF":2.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to low back pain clinical guidelines in Australian hospital emergency departments: A public and private comparison","authors":"Claire L. Samanna ,&nbsp;Paul Buntine ,&nbsp;Daniel L. Belavy ,&nbsp;Ron V. Sultana ,&nbsp;Clint T. Miller ,&nbsp;Vasilios (Bill) Nimorakiotakis ,&nbsp;Patrick J. Owen","doi":"10.1016/j.auec.2024.07.001","DOIUrl":"10.1016/j.auec.2024.07.001","url":null,"abstract":"<div><div>Managing LBP via clinical practice guidelines in healthcare settings is recommended, yet burgeoning evidence suggests adherence is suboptimal in emergency department settings. Whether adherence differs between public and private settings is unknown. A retrospective audit of two Australian emergency departments matched 86 private patients to 86 public patients by age ( ± 5 years), sex (male/female) and LBP duration (first time/history of LBP). Patient charts were reviewed according to the Australian clinical guidelines for the management of LBP. Guidelines were considered individually and via a collective guideline adherence score (GAS). Management GAS was lower in private patients compared to public patients (d [95 %CI]: −0.67 [−0.98, −0.36], P &lt; 0.001). Public patients were more likely to have documentation of guideline-based advice (OR [95 %CI]: 4.4 [2.4, 8.4], P &lt; 0.001) and less likely to be sent for imaging (OR [95 %CI]: 5.0 [2.6, 9.4], P &lt; 0.001). Private patients were more likely to have documented screening for psychosocial risk factors (OR [95 %CI]: 21.8 [9.1, 52.1], P &lt; 0.001) and more likely to receive guideline-based medication prescriptions at patient discharge (OR [95 %CI]: 2.2 [1.2, 4.2], P = 0.013). Differences exist in public and private hospital emergency department guideline adherence. Exploring barriers and facilitators underpinning these differences will assist in guiding future implementation science approaches.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 276-281"},"PeriodicalIF":2.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paramedic clinical practice guideline development in Australia and New Zealand: A qualitative descriptive analysis","authors":"Sonja Maria ,&nbsp;Marc Colbeck ,&nbsp;Matt Wilkinson-Stokes ,&nbsp;Adam Moon ,&nbsp;Michelle Thomson ,&nbsp;Joel Ballard ,&nbsp;Lachlan Parker ,&nbsp;Fraser Watson ,&nbsp;James Oswald","doi":"10.1016/j.auec.2024.06.003","DOIUrl":"10.1016/j.auec.2024.06.003","url":null,"abstract":"<div><h3>Background</h3><div>This collaborative study by The Australasian College of Paramedicine's Clinical Practice Guidelines (CPG) Working Group aimed to examine CPG development practices in Australian and New Zealand ambulance services.</div></div><div><h3>Methods</h3><div>Employing a qualitative descriptive design, the research utilised thematic analysis to extract insights from interviews with eleven experts actively involved in CPG development. The study embraced a nominalist and constructivist approach, recognising the intricate connection between individual experiences and the realities of CPG development in the paramedic field.</div></div><div><h3>Results</h3><div>Key findings revealed significant heterogeneity in CPG development practices, emphasising a lack of formal training and a substantial reliance on existing guidelines. The study highlighted challenges in project management flexibility, limited research capacity, and inconsistencies in external consultations and resource utilisation.</div></div><div><h3>Conclusion</h3><div>The study recommends adopting project management frameworks, investing in training, and utilising evidence evaluation methodologies like GRADE. It emphasises the need for multidisciplinary teams and formal expertise in evidence synthesis, advocating for targeted training programs. Funding challenges highlight the importance of dedicated budgets and collaborative efforts for resource allocation. Knowledge translation and implementation issues underscore the significance of training programs for evidence evaluation and knowledge translation in overcoming these challenges.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 259-267"},"PeriodicalIF":2.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of diagnostic tests in elderly patients consulting the emergency department. Analysis of the emergency department and elder needs cohort (EDEN-8)","authors":"Javier Jacob ,&nbsp;Elena Fuentes ,&nbsp;Juan González del Castillo ,&nbsp;Inmaculada Bajo-Fernández ,&nbsp;Aitor Alquezar-Arbé ,&nbsp;Eric Jorge García-Lamberechts ,&nbsp;Sira Aguiló ,&nbsp;Cesáreo Fernández-Alonso ,&nbsp;Guillermo Burillo-Putze ,&nbsp;Pascual Piñera ,&nbsp;Pere Llorens ,&nbsp;Sònia Jimenez ,&nbsp;Adriana Gil-Rodrigo ,&nbsp;Jorge Sánchez Tembleque-Sánchez ,&nbsp;Maria Pilar López-Diez ,&nbsp;Marta Iglesias-Vela ,&nbsp;Rafael Antonio Pérez-Costa ,&nbsp;Marién López-Pardo ,&nbsp;Rebeca González-González ,&nbsp;Marina Carrión-Fernández ,&nbsp;Òscar Miró","doi":"10.1016/j.auec.2024.06.004","DOIUrl":"10.1016/j.auec.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).</div></div><div><h3>Methods</h3><div>We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied. The association was analysed by calculating the adjusted odds ratios (aOR) and their 95 % confidence intervals (CI) using a logistic regression model.</div></div><div><h3>Results</h3><div>A total of 25,557 patients were analysed. There was an increase in the use of diagnostic tests based on age, with an aOR for blood test of 1.805 (95 %CI 1.671 – 1.950), ECG 1.793 (95 %CI 1.664 – 1.932) and X-ray 1.707 (95 %CI 1.583 – 1.840) in the group of 85 years or more. The use of diagnostic tests is lower in the female population. Most ageing characteristics (cognitive impairment, previous falls, polypharmacy, dependence, and comorbidity) were independently associated with increased use of diagnostic tests.</div></div><div><h3>Conclusions</h3><div>Age, and the characteristics of ageing itself are generally associated with a greater use of diagnostic tests in the ED.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 268-275"},"PeriodicalIF":2.1,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536043","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}

{"title":"What are the training needs of emergency department resuscitation nurses? A scoping review","authors":"Josephine Rheinberger ,&nbsp;Kate Curtis ,&nbsp;Andrea McCloughen ,&nbsp;Taneal Wiseman","doi":"10.1016/j.auec.2024.06.001","DOIUrl":"10.1016/j.auec.2024.06.001","url":null,"abstract":"<div><h3>Background</h3><div>The emergency resuscitation nurse is a challenging and specialised role at the forefront of critical care<span> practice in the emergency department. Despite their extensive specialist knowledge and skill requirements, in Australia there is no state-wide or nationally agreed approach to how to best provide training that meets a set of fixed objectives and requisite skills for resuscitation nurses. Due to an ageing nursing population and increasing workforce attrition, an efficacious accelerated pathway to acquire specialist resuscitation nursing knowledge, is necessary.</span></div></div><div><h3>Aim</h3><div>The aim of this review is to identify, consolidate and summarise the available evidence on the training needs for the requisite clinical and non-technical skills of emergency resuscitation nurses</div></div><div><h3>Eligibility criteria</h3><div><span>Papers about nurses currently working in the emergency department; including Nurse Unit Managers (NUMs), Clinical Nurse Educators (CNEs), Clinical </span>Nurse Consultants<span><span> (CNCs), Clinical Nurse Specialists (CNSs), </span>Registered Nurses (RNs) and Enrolled Nurses (ENs) were included. The review included primary and non-primary research, including papers addressing how emergency nurses are trained. There was no date limitation set to ensure all results could be reviewed. Papers that were not published in English, included nurses who were not working in the ED, or included doctors, allied health, and other staff where population cohorts could not be distinguished, were excluded. Abstract only, editorials, conference posters or oral presentations, were also excluded.</span></div></div><div><h3>Sources of evidence</h3><div>Searches were conducted in MEDLINE, CINAHL and EMCARE. The authors conducted extensive hand-searching of the included study reference lists as well as the grey literature to ensure that all relevant literature was captured.</div></div><div><h3>Methods</h3><div>A scoping literature review was conducted.</div></div><div><h3>Results</h3><div>Data extraction was conducted on the final 33 articles (23 peer reviewed studies and 10 competency and practice standards documents). Specific training requirements to achieve competence in the requisite clinical and non-technical skills in resuscitation nursing do not exist. A decline in competency without regular reinforcement was reported. Multi-modal approaches, incorporating diverse teaching methods, show potential in enhancing knowledge retention and skill acquisition.</div></div><div><h3>Conclusion</h3><div>Resuscitation nursing lacks a standardised training approach in Australia, leading to a gap in ensuring consistent skill acquisition and knowledge among nurses. Research is required to identify what resuscitation nursing skills and training are necessary to ensure practice effectively meets the needs of patients.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 244-253"},"PeriodicalIF":2.1,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536044","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}

{"title":"Determinants of work stress among emergency department nurses in Sleman, Yogyakarta, Indonesia","authors":"Happy Indah Kusumawati ,&nbsp;Suis Galischawati ,&nbsp;Sri Warsini ,&nbsp;Bayu Fandhi Achmad ,&nbsp;Nurul Aida Fatma ,&nbsp;Nazhifah Salsabila Tiyani ,&nbsp;Dewi Nirmalasari ,&nbsp;Eko Budi Santoso","doi":"10.1016/j.auec.2024.06.002","DOIUrl":"10.1016/j.auec.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>The nursing field is the fourth most stressful occupation in the health sector. Emergency department nurses often face crises and unpredictable situations that can negatively affect their quality of life and the quality of care. This study aimed to investigate the determinants of work stress among ED nurses in Sleman, Yogyakarta, Indonesia.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional study was conducted. Participants (n = 122) were emergency nurses recruited through convenience sampling from four EDs in Sleman District, Yogyakarta, Indonesia. Data were gathered using an online self-administered survey consisting of the workload, self-efficacy, and work stress questionnaires. Hierarchical linear regression analysis with the entry method was used to examine the main determinants of work stress.</div></div><div><h3>Results</h3><div>The average work stress (38.29 ± 8), workload (30.83 ± 9.21), and self-efficacy (32.47 ± 3.61) scores were at a moderate level. Hierarchical linear regression showed that workplace, being a head nurse, and workload were the main determinants that contributed to 25.4 % of work stress among ED nurses.</div></div><div><h3>Conclusions</h3><div>The study results confirm that having a high workload, working in a private hospital, and being a head nurse are the main determinants of work stress among ED nurses in Sleman, Indonesia.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 254-258"},"PeriodicalIF":2.1,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494409","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}

{"title":"The experiences of patients not conveyed after evaluation by emergency medical services in Southwest Finland – A qualitative survey study","authors":"Anne Kuoppala ,&nbsp;Eetu Skaffari ,&nbsp;Timo Iirola ,&nbsp;Hilla Nordquist","doi":"10.1016/j.auec.2024.05.001","DOIUrl":"10.1016/j.auec.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><div>The amount of non-critical Emergency Medical Services missions has been increasing. After examination and treatment, paramedics can decide, based on guidelines, not to convey the patient to a healthcare facility. This study aimed to investigate patients’ experiences in non-conveyance situations in Southwest Finland. Our research questions were: 1) Which patient concerns were not addressed? 2) What key actions improved patient comfort? and 3) What possible enhancements could make the patient experience more positive?</div></div><div><h3>Methods</h3><div>This was a qualitative survey study. In March 2023, all the patients who met the inclusion criteria (N = 1017) received a survey via mail. The data from three open-ended questions were analyzed using inductive content analysis.</div></div><div><h3>Results</h3><div>The response rate was 22.2 % (n = 226). The unaddressed patient concerns were related to inadequate immediate care and guidance and non-clinical factors causing concern. Key actions for improved patient comfort were related to immediate treatment and guidance, as well as non-clinical factors that impact the patient experience. More thorough treatment processes and more attentive encounters would have enhanced the patient experience.</div></div><div><h3>Conclusions</h3><div>Predominantly, patients reported having received excellent services. Utilizing paramedics’ soft skills and keeping the patient as the central focus is key to improving the non-conveyance process and experience.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 237-243"},"PeriodicalIF":2.1,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring paramedic personality profiles and the relationship with burnout and employment retention: A scoping review","authors":"Chloe Betts,&nbsp;Alannah Stoneley,&nbsp;Tara Picker","doi":"10.1016/j.auec.2024.04.003","DOIUrl":"10.1016/j.auec.2024.04.003","url":null,"abstract":"<div><h3>Background</h3><div>Paramedics play a pivotal role in delivering emergency medical care, contributing to excellence in the prehospital environment and ensuring a seamless continuum of healthcare. Achieving this objective is subject to various factors. This review aims to explore, the relationship between paramedic personality profiles and key factors including stress, burnout and employment retention or attrition.</div></div><div><h3>Methods</h3><div>The JBI approach was used to perform a scoping review. Key words including paramedic* , ambulance* , personalit* , retention OR attrition and burnout OR stress were inserted into the search engines OVID, CINAHL Plus, Scopus, Web of Science Core Collection, Psychology ProQuest, and Nursing ProQuest. Titles and abstracts of 226 results were screened and inclusion and exclusion criteria applied. Full texts of the remaining 18 results were screened to inform the results.</div></div><div><h3>Results</h3><div>Three themes emerged relevant to the objective including the correlation of neuroticism with stress and burnout, personality types and mental illness with the ability to cope during stressful situations and finally resilience and burnout with the intention to quit.</div></div><div><h3>Conclusion</h3><div>Further research should be completed into specific personality characteristics, including neuroticism, perfectionism, and excitability to facilitate the development of strategies aimed at improving the health and wellbeing of paramedics and EMT workers internationally.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 227-236"},"PeriodicalIF":2.1,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141079624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vital signs monitoring in Australasian emergency departments: Development of a consensus statement from ACEM and CENA","authors":"","doi":"10.1016/j.auec.2024.04.001","DOIUrl":"10.1016/j.auec.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Emergency Department (ED) care is provided for a diverse range of patients, clinical acuity and conditions. This diversity often calls for different vital signs monitoring requirements. Requirements often change depending on the circumstances that patients experience during episodes of ED care.</p></div><div><h3>Aim</h3><p>To describe expert consensus on vital signs monitoring during ED care in the Australasian setting to inform the content of a joint Australasian College for Emergency Medicine (ACEM) and College of Emergency Nursing Australasia (CENA) position statement on vital signs monitoring in the ED.</p></div><div><h3>Method</h3><p>A 4-hour online nominal group technique workshop with follow up surveys.</p></div><div><h3>Results</h3><p>Twelve expert ED nurses and doctors from adult, paediatric and mixed metropolitan and regional ED and research facilities spanning four Australian states participated in the workshop and follow up surveys. Consensus building generated 14 statements about vital signs monitoring in ED. Good consensus was reached on whether vital signs should be assessed for 15 of 19 circumstances that patients may experience.</p></div><div><h3>Conclusion</h3><p>This study informed the creation of a joint position statement on vital signs monitoring in the Australasian ED setting, endorsed by CENA and ACEM. Empirical evidence is needed for optimal, safe and achievable policy on this fundamental practice.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 3","pages":"Pages 207-217"},"PeriodicalIF":2.1,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X24000228/pdfft?md5=67da3fa112be55f99e1df1c1253cea70&pid=1-s2.0-S2588994X24000228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The significance of paramedic communication during women’s birth experiences: A scoping review","authors":"","doi":"10.1016/j.auec.2024.04.002","DOIUrl":"10.1016/j.auec.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Internationally, over one-third of women experience birth trauma, leading to adverse mental health outcomes. Poor communication with healthcare professionals is a primary contributing factor. Paramedics attend various clinical presentations, including childbirth, yet their potential impact on women's birth experiences has been largely overlooked.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted following the Joanna Briggs Institute methodological framework. The search identified 1015 potentially suitable articles, and 5 articles met the inclusion criteria. Data was analysed using reflexive thematic analysis from a feminist standpoint.</p></div><div><h3>Results</h3><p>Three themes were generated: 1. <em>First Impressions Count:</em> paramedic demeanour impacted the woman's sense of safety and perception of paramedic clinical competence. 2. <em>Choice as a Pathway to Control:</em> when paramedics involved women in decision-making, it led to empowerment, while non-involvement led to women becoming passive participants. 3. <em>Exposed, Violated and Disempowered:</em> some paramedics disrespected and abused women, treating them solely as objects for the purpose of producing a baby.</p></div><div><h3>Conclusions</h3><p>This review highlights the influence of paramedic communication on women's birth experiences. While some paramedics communicated respectfully, other paramedics were the perpetrators of Obstetric Violence. Future research should inform paramedic education and improve outcomes for birthing women.</p></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 3","pages":"Pages 218-226"},"PeriodicalIF":2.1,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2588994X2400023X/pdfft?md5=db073b87497e7113f51febc56284a211&pid=1-s2.0-S2588994X2400023X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}