Paramedic PapersHome Daily scans 18 August 2026
Daily scan
Paramedic research, 18 August 2026
8 new paramedic and prehospital papers from the 18 August 2026 scan.
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Prolonged fasting raises defibrillation needs in pigs
Porcine model of ventricular fibrillation cardiac arrest found that prolonged fasting-induced lower pre-arrest glycemia was associated with increased defibrillation requirements (median 2 vs 1 shock) and longer CPR duration, despite similar sustained ROSC rates.
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Trauma quality improvement opportunities by cohort
Registry-based cohort study of 8,298 trauma patients found that blunt multisystem cohorts had the highest opportunities-for-improvement rates (10.6% with TBI, 16.9% without) across multiple quality domains including potentially preventable deaths and clinical judgement errors.
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Gender gaps in Nordic EMS workplace
Scoping review of gender-related findings in Nordic EMS found women reported higher physical and psychosocial work demands, greater concerns about violence, and higher levels of mental health problems and sleep disturbances compared to male colleagues.
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Online medical direction mostly for refusals
Retrospective analysis of 9,944 online medical direction consultations from 2016-2024 found OLMD is primarily used for patient refusals (65%) with 97% physician approval, and overall ~93% agreement between paramedic requests and physician decisions
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Loss of pulsatility predicts death after ECPR
Retrospective cohort of 221 ECPR patients found loss of pulsatility (zero pulse pressure) occurred in 49% of cases and was associated with significantly higher in-hospital mortality (74% vs 48%), with each additional hour of non-pulsatility increasing mortality risk by 17%
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Who makes non-urgent ED visits
Systematic review of 32 studies across 21 countries identified factors associated with non-urgent ED utilisation, with frequent prior ED visits (aOR up to 82) and patient perception of non-serious illness (aOR up to 21) being the strongest predictors
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CPR leader app no help in simulation
Randomized simulation trial of 40 teams testing the 'CPR Leader' app during in-hospital cardiac arrest found no meaningful improvement in team performance, non-technical skills, or ALS algorithm adherence compared to control
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AR decision support grabs clinician gaze
Secondary analysis of a pediatric cardiac arrest simulation trial found AR-based decision support captured 42-59% of visual attention with distinct role-specific fixation patterns among team leaders and medication nurses