Last month saw pre-hospital and emergency care professionals from around the globe gather for the first European Emergency Medical Services (EMS) Congress in Copenhagen.
Emergency Medical Services (EMS) have expanded their capability over several decades. Despite advances in pre-hospital training, patients must still be transported to emergency departments (ED).
The Larrey Society is an independent cross-sector think tank formed in 2015 in England to help influence fit for purpose ambulance services to meet the needs of all patients in the 21st century. Its founder and chairman, David Davis, provides a background to the organisation and its global forum used by members.
Clinical handover at the paramedic/emergency department (ED) interface is a potentially critical episode in the patient care journey, as omission of information can adversely affect subsequent actions and the treatment provided in the ED.
Even though patient handoffs are at high risk for errors and adverse events, there is not a standardised approach to how these should be taught to paramedic students. The goal of this study was to evaluate the feasibility and effectiveness of implementing a lecture-based training involving the IMIST-AMBO mnemonic in paramedic education.
Paramedic students were randomised into a control group of standard national paramedicine curriculum and an intervention group who received an additional EMS patient handover lecture including IMIST-AMBO protocol. Outcomes were measured through simulation exercises, with learners randomised to either a low-fidelity tabletop or high-fidelity mannequin-based session.
There were three paramedic student teams in each arm of the study. There were no statistical differences in the reporting of any of the IMIST-AMBO components or the total number reported between the control and the intervention group. The intervention group took significantly longer to give their patient handoff: 78.2 s versus 49.2 s.
The formal education on patient handoffs was successfully implemented. There was a trend toward more data being reported in the intervention group but this came at the cost of a significantly longer report.
We were able to successfully implement formal education on patient handoffs but the small size of the study limited the ability to evaluate its effectiveness. Patient handoffs are a high-risk area in medicine and more studies are needed to determine the most effective way to teach this to paramedic students.