EFFECTIVENESS OF PARAMEDIC INTERVENTIONS IN PRE-HOSPITAL EMERGENCY CARE: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.48047/ga9kkf15Palabras clave:
Paramedic, Pre-hospital care, Emergency medical services, Intervention effectiveness, Patient outcomes, Systematic review.Resumen
Background: Pre-hospital emergency care plays a critical role in reducing morbidity and mortality among patients experiencing acute medical and traumatic events. Paramedics serve as frontline responders, delivering rapid, often life-saving interventions before hospital arrival. As the scope of paramedic practice continues to expand, evaluating the effectiveness of these interventions is essential to improving outcomes and optimizing emergency medical services (EMS) systems.
Objective: This systematic review aims to assess the effectiveness of paramedic-led interventions in pre-hospital emergency care, focusing on clinical outcomes, patient safety, and response efficiency.
Methods: A comprehensive literature search was conducted across five major databases (PubMed, Scopus, Web of Science, CINAHL, and EMBASE) for peer-reviewed studies published between 2016 and 2024. Eligible studies included randomized controlled trials, cohort studies, and observational research evaluating clinical outcomes of paramedic-administered interventions. Data extraction and quality assessment were performed independently by two reviewers following PRISMA guidelines.
Results: Out of 2,347 identified records, 42 studies met the inclusion criteria. Interventions analyzed included airway management, defibrillation, hemorrhage control, analgesia, stroke identification, and early sepsis treatment. Evidence suggests that timely paramedic interventions are associated with improved survival rates in cardiac arrest, better pain management, and faster recognition of time-sensitive conditions such as stroke and sepsis. However, variations in protocols, training levels, and patient populations limited the ability to generalize some findings.
Conclusion: Paramedic-led interventions in the pre-hospital setting are generally effective in improving patient outcomes, particularly when guided by standardized protocols and supported by continuous training. Further high-quality research is needed to strengthen the evidence base and support the development of best-practice models in EMS systems.
Descargas
Referencias
• Ahern, T. L., Heitz, C., Wiebe, D. J., & Fisher, J. (2021). Efficacy of prehospital analgesia: A systematic review of randomized controlled trials. American Journal of Emergency Medicine, 49, 102–109. https://doi.org/10.1016/j.ajem.2021.06.003
• Al Abbas, H. M. A., Al Hussin, Y. M. M., Al hussain, A. M., Alabbas, M. A. S., Al-Duways, R. M., Alhareth, H. S. M., Al-Bakri, M. A. S., Alabass, A. H. A., Alwadai, A. A. M., & Alwadai, A. M. T. (2024). Evaluating the Impact of Emergency Medical Services on Patient Outcomes: A Systematic Review. Journal of Ecohumanism, 3(8), 9048–. https://doi.org/10.62754/joe.v3i8.5522
• Behrens, K., Petzoldt, M., Schewe, J. C., & Gräsner, J.-T. (2023). Impact of paramedic intervention on outcomes in out-of-hospital cardiac arrest: A systematic analysis. Resuscitation, 187, 109631. https://doi.org/10.1016/j.resuscitation.2023.109631
• Bray, J., Nehme, Z., Nguyen, A., Lockey, A., & Finn, J. (2020). A systematic review of the impact of emergency medical service practitioner experience and exposure to out-of-hospital cardiac arrest on patient outcomes. Resuscitation, 151, 77–84. https://doi.org/10.1016/j.resuscitation.2020.04.031
• Burrell, M., Goodwin, J., & Jenkins, J. (2022). Expanding paramedic scope of practice in prehospital care: Opportunities and challenges. BMC Emergency Medicine, 22(1), 81. https://doi.org/10.1186/s12873-022-00615-9
• Delaney, P. G., Bamuleke, R., & Lee, Y. J. (2018). Lay First Responder Training in Eastern Uganda: Leveraging Transportation Infrastructure to Build an Effective Prehospital Emergency Care Training Program. World Journal of Surgery, 42(8), 2293–2302. https://doi.org/10.1007/s00268-018-4488-2
• Delaney, P. G., Eisner, Z. J., & Thullah, A. H. (2021). Evaluating a Novel Prehospital Emergency Trauma Care Assessment Tool (PETCAT) for Low- and Middle-Income Countries in Sierra Leone. World Journal of Surgery, 45(6), 1768–1776. https://doi.org/10.1007/s00268-021-06011-2
• Delaney, P. G., Eisner, Z. J., Ssekalo, I., Kazungu, R., & Blackwell, T. S. (2021). Exploring the factors motivating continued Lay First Responder participation in Uganda: a mixed-methods, 3-year follow-up. Emergency Medicine Journal, 38(1), 8–13. https://doi.org/10.1136/emermed-2020-209429
• Eisner, Z. J., Delaney, P. G., Thullah, A. H., Yu, A. J., & Timbo, S. B. (2020). Evaluation of a Lay First Responder Program in Sierra Leone as a Scalable Model for Prehospital Trauma Care. Injury, 51(11), 2437–2443. https://doi.org/10.1016/j.injury.2020.09.003
• Hancock, C. J., Delaney, P. G., Eisner, Z. J., Kroner, E., & Mahamet-Nuur, I. (2020). Developing a Lay First Responder Program in Chad: A 12-Month Follow-Up Evaluation of a Rural Prehospital Emergency Care Program. Prehospital and Disaster Medicine, 35(5), 531–536. https://doi.org/10.1017/S1049023X20000815
• Ingstad, K., Strandås, M., Vizcaya-Moreno, M. F., Sepp, J., & Linnik, L. (2024). An Integrative Systematic Review of Promoting Patient Safety Within Prehospital Emergency Medical Services by Paramedics: A Role Theory Perspective. Journal of Multidisciplinary Healthcare, 17, 1–14. https://doi.org/10.2147/JMDH.S379268
• Lockey, D., Crewdson, K., Weaver, A., & Davies, G. (2014). Observational study of the success rates of intubation and failed intubation airway rescue techniques in 7256 attempted intubations of trauma patients by pre-hospital physicians. British Journal of Anaesthesia, 113(2), 220–225. https://doi.org/10.1093/bja/aeu227
• Lindström, V., Bohm, K., Kurland, L., & Castrén, M. (2021). Prehospital emergency care and patient outcomes: A review of evidence on systems and interventions. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1), 51. https://doi.org/10.1186/s13049-021-00878-5
• Mackintosh, N., Rainey, H., & Sandall, J. (2012). Understanding how rapid response systems may improve safety for the acutely ill patient: learning from the frontline. BMJ Quality & Safety, 21(2), 135–144. https://doi.org/10.1136/bmjqs-2011-000147
• Milligan, J., Lee, A., Gill, M., Weatherall, A., Tetlow, C., & Garner, A. (2016). Performance comparison of improvised prehospital blood warming techniques and a commercial blood warmer. Injury, 47(9), 1922–1926. https://doi.org/10.1016/j.injury.2016.06.015
• Neagle, G., Curatolo, L., Ferris, J., Donald, M., & Hearns, S. (2019). Epidemiology and location of primary retrieval missions in a Scottish aeromedical service. European Journal of Emergency Medicine.
Descargas
Publicado
Número
Sección
Licencia
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Usted es libre de:
- Compartir — copiar y redistribuir el material en cualquier medio o formato para cualquier propósito, incluso comercialmente.
- Adaptar — remezclar, transformar y construir a partir del material para cualquier propósito, incluso comercialmente.
- La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia
Bajo los siguientes términos:
- Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios . Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
- No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
