Australasian Journal of Paramedicine

Introduction There is ubiquitous belief that right ventricular myocardial infarction (RVMI) patients are pre-load dependent, and that administering nitrates to this cohort may cause adverse events – most notably hypotension. This article charts a narrative history of RVMI and nitrates: from the initial recognition of RVMI and early support of the use of nitrates, through the spread of the view against nitrates, and to the recent publication of evidence once again supporting their use. Methods Four databases were systematically searched (PubMed, Embase, Medline, Web of Science) and results screened by title, then abstract, and finally full text. Results were presented using a chronological narrative structure. Results The view against the use of nitrates during RVMI can be traced back to a single 1989 cohort study of 28 patients, then later being adopted by a series of influential secondary evidence papers, and ultimately by international guidelines. In 2016, 2017 and 2019, new cohort studies totalling 1046 patients were presented, all of which concluded that nitrates are safe to administer during RVMI. Conclusion This article charts how a single retrospective cohort study with low statistical power came to form the dominant narrative on best practice despite complex and conflicting primary evidence.

Matt Wilkinson-Stokes

Right Ventricular Myocardial Infarction and Adverse Events from Nitrates: A Narrative Review

右心室心肌梗死与硝酸盐类药物不良事件：叙述性综述

Introduction The scope of paramedic practice is being redefined and expanded. Professional development and clinical expertise are not only necessary for paramedics to perform their clinical functions and operational responsibilities, they are at the very core of their professionalisation. Professionalisation is a complex process, and the degree to which it can accomplished will impact society's perception of the profession – and its trust in it – for years to come. This study investigated ways to enhance professional practice, from the point of view of the main healthcare providers in a rural area of Ontario, Canada. Methods A qualitative analysis informed by action research methodology was used. The research design was staged and consisted of focus groups and a World Café. The data were coded and organised into themes, using thematic analysis, and were triangulated with the literature. Results Three key themes emerged from the World Café and focus group conversations including current enablers of professionalisation; system components that promote professionalism; and community of practice to support professional development and clinical expertise. Conclusion Paramedic practice is evolving. This should be reflected in clinical practice and education, and more paramedic-led research. Paramedic training may need to move from the college to the university environment to reflect equal standing with colleagues in the broader healthcare system. This study shows strong motivation among paramedics and management to enhance professional practice and professionalism. To achieve this, a culture of trust, developing engagement and communication strategies and establishing a community of practice are crucial.

Mathieu Grenier

Julia van Vuuren

Evelien Spelten

Enhancing Professional Practice and Professionalism among Canadian Rural Paramedics

提高加拿大农村护理人员的专业实践与专业精神

Introduction Previous studies have shown teaching public health in medical courses improves students’ analytical, problem-solving and communication skills. However, little research to date has shown if public health teaching is helpful to paramedic students. The aim of this study was to examine if having paramedic tutors teach public health had a positive effect on students’ learning and interest in public health. Methods 184 second-year paramedic students at an Australian university completed a printed survey and provided feedback about their learning experience. Students answered multiple choice and open-ended questions about whether their understanding of a public health subject was improved by having a paramedic tutor, and if having different tutors each week affected students’ learning. Results Most students reported their understanding of public health improved when the subject was taught by a paramedic tutor and when paramedic scenario examples were included in teaching. Nearly half felt having different tutors each week made learning difficult. The following themes emerged from student narratives: the relevance of public health to their career; an improved understanding of public health; a realisation about the importance of public health; difficulties presented by an inconsistent teaching style; and poor follow-up and conflicting advice. Conclusion Teaching public health from a paramedic perspective enabled students to understand the relevance of paramedic practice and the role paramedics play in the public health system. Having the same paramedic tutor teaching each week helped students understand the relationship between public health and paramedic practice.

Marguerite Claire Sendall

Athena Ng

Laura McCosker

Undergraduate Paramedic Students’ Experience of Paramedic Tutors Teaching Public Health

本科护理学生对护理导师教授公共卫生课程的体验

Introduction Even with paramedicine's evolution, clinical decision-making will always be a crucial learning and teaching requirement. As part of their learning, paramedic students need to develop critical thinking and collaborative approaches with others. The aim was to review the literature around escape room activity as a pedagogical approach for paramedic education. The intent is to contribute to the discussion around authentic and engaging approaches to teaching clinical thinking and decision making in paramedicine. Methods A systematic review was undertaken to review existing literature on using this approach in higher education. EBSCO, Medline, CINAHL, ScienceDirect, ProQuest and PubMed were used to review paramedic and health education strategies using a list of keywords. Results There were 23 scholarly papers examining the use of escape rooms in an educational context found. There was no reference to using this teaching methodology in paramedicine, but some health contexts were identified for nursing, pharmacy, radiology and medicine. Conclusion With an instructional design that addresses logistical requirements, educational escape rooms can be used effectively in paramedic higher education. This review highlights a longitudinal study is needed to assess an educational escape room's implementation into the paramedic higher education curriculum. A longitudinal, multi-university study can further explore the feasibility of using a blended online/offline escape room activity in large enrolment paramedic programs.

Shannon Delport

Anthony Weber

Escape Rooms in Paramedic Education

紧急救护教育中的密室逃脱

The coronavirus disease (COVID-19), caused by the virus SARS-CoV-2, has strained international healthcare systems, including ambulance availability. Ambulance officers and paramedics are at the frontline of this pandemic and are therefore particularly exposed. Under normal operational circumstances, ambulance delivery is challenging; the effects of COVID-19 have exacerbated both the delivery of services and the stress placed on paramedics. In this case report, we describe a 12-hour emergency ambulance dayshift in central London during the second wave city-wide lockdown. We also discuss the impact COVID-19 has on day-to-day operations and the strategies employed to reduce paramedic infection.

Alexandra Rengers

Emma Day

Steve Whitfield

Describing a 12-Hour Ambulance Shift during a Second Wave of Covid-19 in London

描述伦敦第二波新冠疫情期间12小时救护车班次

Introduction The societal changes triggered by the COVID-19 pandemic and resultant lockdowns have the potential to alter the incidence and nature of injuries within affected populations. We aimed to investigate these changes within Metropolitan London and the impact lockdown had on London's Air Ambulance's (LAA) response to incidents. Methods This retrospective cohort study compared data from all LAA missions in the two-month period following instigation of the 1st UK national lockdown in 2020 to the equivalent period in 2019. Patient demographics, nature and severity of injuries, incident details and LAA mission parameters were assessed. Results LAA saw a significant reduction in the mean (standard deviation) of activations per week under lockdown (32.75 [4.95] versus 54.25 [4.53], p&lt;0.001). The distribution of patients across different trauma aetiologies differed significantly under lockdown, with proportionately more injuries resulting from domestic violence (0.7% versus 3.8%) and deliberate self-harm (DSH [16.5% versus 12.4%]), although the absolute number of DSH fell. Significantly fewer incidents occurred in central areas of London, but injury severity was unaffected by lockdown. After adjustment for confounders, lockdown was associated with shorter drive times, but not overall response times. There was no association between lockdown and aetiology or severity of injuries. Conclusion The COVID-19 pandemic and ensuing UK national lockdown had a substantial impact on major trauma patterns within London and the subsequent LAA response. The feared rise in suicide was not observed, but there was a notable increase in domestic violence frequency.

Andrew Milne

Rory Saggers

Tom P. Hurst

Christine L. Henry

Michael Christian

Impact of the UK National Lockdown on Trauma Patterns and the Prehospital Advanced Trauma Team Response within Metropolitan London

英国全国封锁对大伦敦地区创伤模式及院前高级创伤团队响应的影响

Introduction The study of human anatomy forms a foundational knowledge base essential for healthcare professional practice including paramedicine. However, little is known about the experiences and perceptions of undergraduate student paramedics towards learning anatomy. The aim of this study was to investigate this, utilising a questionnaire previously validated in medical students. Methods To explore anatomy learning experiences, a 32-item anatomy learning experiences questionnaire (ALEQ) modified for use with paramedicine students was distributed online to students enrolled in the Bachelor of Paramedic Practice at the University of Tasmania. Quantitative statistics were used to identify differences in responses between student groups. Cronbach's alpha assessed the reliability of the modified ALEQ. Results Fifty-one usable responses were obtained (20% response rate). Psychometric analysis demonstrated good overall reliability (Cronbach's alpha of 0.88). The students perceived several learning activities as positive including textbooks, online learning and practical classes. However, it was generally felt the amount of content to learn was daunting. Furthermore, the students indicated working with cadavers would be highly beneficial for their learning. The relevance of anatomy was also recognised as being important to future clinical practice. Conclusion Despite the low response rate, the modified ALEQ was a reliable instrument to investigate the anatomy learning experiences and perceptions of paramedicine students. Further research with a larger cohort is required to confirm the reliability and generalisability of the results.

Anthony Carnicelli

Anne-Marie Williams

Dale Edwards

Investigating the Anatomy Learning Experiences of Undergraduate Paramedic Students

探究本科护理学生解剖学学习体验

“Change is the law of life, and those who look only to the past or present are certain to miss the future.” John F Kennedy The Australasian College of Paramedicine (ACP) has a distinguished history of supporting, promoting and disseminating research in paramedicine. Central to that outcome has been its longstanding commitment to scientific journal publishing by way of what is currently our journal, the Australasian Journal of Paramedicine. In November 2021, AJP commenced a hiatus on new submissions that will continue until mid-2022. An interim Editor in Chief, Associate Professor Paul Simpson, was appointed to oversee the operations concurrent to a transition strategy being developed. A Journal Advisory Committee (‘JAC’) with international membership was tasked to advise the College on the future direction of the College’s Journal. The JAC have consulted widely with researchers in and outside of paramedicine, and with experienced leaders in the journal publishing space, to identify best practice models that will be sustainable and give the Journal the best opportunity to grow and prosper into the future. It is expected that the new Journal will launch in early 2023, heralding a new decade of excellence and progression with a stronger international focus and a resolute commitment to progressing the scientific discourse in paramedicine. The reopening of submissions for the first edition of the relaunched journal is expected in October 2022.

Paul Simpson

A New Era of Opportunity – Securing Excellence for Our Journal

新时代的机遇——确保我们期刊的卓越地位

Aims The Hunter-8 and the ACT-FAST are stroke scales used in Australia for the pre-hospital identification of large vessel occlusion (LVO) stroke but have not previously been compared. Moreover, their use in identifying distal arterial occlusions has not previously been assessed. We therefore aimed to describe the area under the receiver operating curve (AUC) of the Hunter-8 versus the ACT-FAST for the detection of classic LVO. Methods Both scales were performed on consecutive patients presenting with stroke-like symptoms within 24 hours of symptom onset presenting to the emergency department at a tertiary referral hospital between June 2018 and January 2019. The AUC of the Hunter-8 and the ACT-FAST was calculated for the detection of LVO using different definitions [classic LVO (proximal segment of the middle cerebral artery (MCA-M1), terminal internal carotid artery (T-ICA), or tandem occlusions) and extended LVO (classic LVO plus proximal MCA-M2 and basilar occlusions)]. Results Of 126 suspected stroke patients, there were 24 classic LVO and 34 extended LVO. For detection of classic LVO, the Hunter-8 had an AUC of 0.79 and the ACT-FAST had an AUC of 0.77. For extended LVO, the AUC was 0.71 and 0.70 respectively. Conclusion Both scales represent a significant opportunity to identify patients with proven potential benefit from thrombectomy (classic LVO), however M2 and basilar occlusions may be more challenging to identify with these scales.

Cecilia Ostman

Carlos Garcia-Esperon

Thomas Lillicrap

Khaled Alanati

Beng Lim Alvin Chew

Jennifer Pedler

Sarah Edwards

Mark Parsons

Christopher Levi

Neil Spratt

Comparison of Two Pre-Hospital Stroke Scales to Detect Large Vessel Occlusion Strokes in Australia: A Prospective Observational Study

澳大利亚两种院前卒中量表检测大血管闭塞性卒中的比较：一项前瞻性观察性研究

Introduction Health care workers employed in the ambulance service should minimize their response time when responding to a medical emergency. Prehospital emergency medical services operate on a 24-h basis; hence, time management in both the work and social lives of the staff is more difficult than in other occupational groups. In the case of emergency health services, time management is no doubt the most important aspect in terms of human health. The purpose of this research was to examine the time management skills and influencing factors of health care workers employed in the ambulance service. Methods In this cross-sectional study, a questionnaire containing time management inventory (TMI) and demographics was applied. In the analysis of the data, the number, chi square, percentage, and t test were applied using SPSS statistical software. Results Of those who participated in the survey, 57.8% were male, 86.2% were working at the emergency medical service station, and 49.9% were paramedics. The average TMI was 70.49. In the time-consumption subdimension of the survey, when the genders of the health care workers who were employed in the ambulance service were compared, there was a statistically significant difference according to education status for the total time management. Conclusion A statistically significant difference was observed with regards to education status for the total time management according to gender for the time loss subdimension of the healthcare workers employed in the ambulance service. This research concluded that males working in the ambulance service managed their use of time better than the females, and that high school graduates used their time better than the undergraduates.

Ismet Celebi

Gülbahar Alkaş

Time Management Attitudes of Health Care Workers Employed in the Ambulance Service in Turkey

土耳其急救服务中医护人员的时间管理态度

ISSN	2202-7270
h-index	18

Publication Information	Publisher: Australasian College of Paramedicine，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2013，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%

Australasian Journal of Paramedicine

Journal Citation Format

A journal article with 1 author

A journal article with 2 authors

A journal article with 3 authors

A journal article with 5 or more authors

Books Citation Format

Thesis Citation Format

Web sites Citation Format

Patent Citation Format

Staying up late manually editing references? ivySCI automatically matches journals and helps you generate references with a single click.

Share Submission Experience