Posted on 01/08/2011
Clinical innovation in pre-hospital care
New research concludes that NHS ambulance trusts could implement schemes using 'advanced' paramedics to improve pre-hospital care and save lives, with negligible impact on their budgets.
Dr Ashok Jashapara evaluated the development of Critical Care Paramedics (CCPs) at South East Coast Ambulance NHS Trust (SECAmb) in the UK. International evidence shows CCPs can make a difference and have an important contribution towards improving patient survival rates.
Who actually delivers care on the ground, be they a doctor or CCP, is not so important according to the report – but as highly trained paramedics are less expensive than doctors, they are more cost effective. The research concluded that the optimal solution would be to develop CCPs in the field, with doctors providing medical support and supervision. However, coordinating and delivering high-risk patients to the best-equipped hospitals or trauma centres in the region would also contribute to reducing mortality rates.
- Other NHS ambulance trusts could develop CCP schemes as part of efforts to improve standards of pre-hospital care and preventable deaths.
- CCPs should be integrated with specialist hospitals, trauma centres and trauma networks – delivering patients to the best-equipped hospital or trauma centre in the region.
- Paramedics with CCP education and training could have a wider role in supporting emergency preparedness, air ambulance services, and specialist operations.
- The most productive and cost-effective solution is likely to be developing paramedics at CCP level in the field, with doctors providing medical support (possibly using telemetry to provide a ‘virtual’ presence), clinical governance and advice as part of a multi-professional team approach.