Considerations on out-of-hospital pain assessment of a diverse population

Nearly all medical emergency calls are related to someone experiencing some form of discomfort—either due to trauma or pain. Initial pain assessment may be undertaken over the telephone by an emergency medical dispatcher, without seeing the patient; however, the next key moment in pain assessment is completed patient-side by the paramedic. This inquiry is detailed and guides the paramedic in the formation of a differential diagnosis and provision of appropriate pain management. The research team recently conducted and published a study on pain assessment which raised concerns on the subjectivity of pain scoring. The work presented was in the context of a very multicultural environment. The aim of this commentary article is to further explore this topic and encourage health professionals to reflect on this aspect of patient assessment.

Emergency practitioners' motivations and acceptance of COVID-19 vaccination

Background: Vaccination against the SARS-CoV-2 virus is an essential contributor to ending the pandemic. Acceptance of the vaccine among emergency medical service (EMS) professionals is largely unknown. Methods: A survey was distributed to EMS professionals. Participants responded to questions about their experiences of COVID-19, if they had received a COVID-19 vaccine, and personal reasons behind their decision for having it. Descriptive statistics were calculated, and multivariate logistic regression was used to produce adjusted odds ratios. Findings: A total of 1087 survey responses were collected. Among respondents, 65% had received a full COVID-19 vaccine dose and 33% had not. Of those who had not, 81% said they were unlikely or very unlikely to receive a vaccine. Certification level, age and education were statistically significant factors for vaccine acceptance. Conclusion: Age, education and certification level are statistically significant factors in COVID-19 vaccine acceptance among EMS professionals. Additional research is needed to identify best practices to combat vaccine hesitancy.

Postprandial hypotension: lessons from Sir Roger Bannister's textbook

In the fourth and final article of the Neurocardiology series, Helen Cowan looks at postprandial hypotension as described in Sir Roger Bannister's textbook and subsequent research.

Trauma education and training for healthcare providers: a scoping review

Background: Every six seconds, someone in the world dies because of injury. Trauma is a major public health problem and leads to significant mortality and morbidity worldwide. Healthcare provider training can affect patient outcomes; therefore, it is useful to examine the efficacy of trauma training programmes. This scoping review aimed to determine the impact of trauma training or education on healthcare providers' confidence. Method: Ovid MEDLINE, Ovid Embase, Ovid Emcare, CINAHL, Scopus, Google Scholar and Trove were systematically searched on 7 August 2021, and a methodology adopted to ensure the scoping review was comprehensive. Results: A total of 749 articles were retrieved, of which 15 were eligible for the scoping review. After the articles were analysed, two themes—knowledge and experience—were identified. Knowledge improved from attending courses. However, knowledge retention fell over time. Participants reported that their confidence improved after attending courses, but an inverted correlation was observed between experience and knowledge. Conclusion: Trauma training courses improve the confidence of healthcare providers. However, these courses should be conducted regularly and trainees observed to assess their confidence. Further studies should be conducted to evaluate the effect of these courses on practitioner confidence.

Racial disparities in emergency care for seizures in the United States

Background Racial disparities exist regarding emergency medical services, and advanced life support (ALS) is superior to basic life support (BLS) for patients experiencing a seizure. Aims This study aims to identify if there are racial disparities regarding access to ALS care for patients having a seizure. Methods This study analysed 624 011 seizure cases regarding the provision of BLS rather than ALS care per racial group. Chi-square testing was used to check statistical significance and effect size was measured using relative risk. Findings On average, non-white patients experiencing a seizure had a 21% higher relative risk of receiving BLS care than white patients. The highest disparity concerned American Indian patients, who had a 66% higher relative risk of receiving BLS care than white patients. Conclusions Overall, non-white patients are less likely to receive ALS when experiencing a seizure than white patients, potentially leading to worse prehospital outcomes from less access to time-critical medications.

Pride in paramedicine: being an LGBTQ+ paramedic

People identifying as LGBTQ+ make up a part of the paramedic community around the world. In this issue of International Paramedic Practice, we hear from paramedics in Ecuador and the UK about their experiences

Building ad-hoc team social capital through simulation

The concept of high-functioning healthcare teams is complex and competencies have been developed primarily from aviation. High-functioning healthcare teams, including those formed in an ad-hoc manner, are crucial to positive patient outcomes. Social capital theory identifies structural, cognitive and relational dimensions involved in the formation of trusting, cohesive relationships. Theories of social capital can be used to advise the development of interprofessional simulation-based education. Interprofessional simulation-based education curricula development must focus on the social sciences if it is to promote strong, healthy team relationships. Simulation-based education should take place in learning environments that promote the development of social capital between team members, especially where teams are formed ad hoc.

Cardiac syncope: lessons learned from Sir Roger Bannister's textbook

In the third article of the new Neurocardiology series, Helen Cowan looks at cardiac syncope and the link between the heart and brain.