Paramedic PapersHome Daily scans 25 August 2026
Daily scan
Paramedic research, 25 August 2026
19 new paramedic and prehospital papers from the 25 August 2026 scan.
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Persistent OHCA inequality across England
Retrospective analysis of 165,701 OHCA patients in England 2018–23 found 23.6% of postcode districts remain high-risk (higher OHCA incidence, lower bystander CPR rates), with urban deprived areas showing 71.2% BCPR versus 79.1% in low-risk areas, though ROSC and survival were slightly higher in high-risk areas.
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Using EMS gear speeds ED rhythm analysis
Video review study of 223 OHCA patients found using EMS equipment for initial ED rhythm analysis reduced median time to first rhythm analysis by 143 seconds and first defibrillation by 131.5 seconds compared with ED equipment.
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Kidney biomarkers predict outcomes after OHCA
Prospective study of 82 comatose OHCA patients found kidney-specific biomarkers (plasma and urinary NGAL and KIM-1, cystatin C) were superior to serum creatinine for early AKI detection and prediction of poor neurological outcomes at discharge.
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Lactate after paediatric OHCA predicts outcome
Secondary analysis of 213 pediatric OHCA patients found higher lactate within 6 hours of ROSC was associated with unfavorable 12-month neurobehavioral outcomes (median 7.8 vs 3.1 mmol/L), with each 1 mmol/L increase increasing odds of unfavorable outcome by 40%.
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Prior ECG abnormalities predict shockable OHCA rhythm
Danish registry study of 22,516 first OHCA patients found prehospital ECG abnormalities (pathological Q-waves, LVH, AF, conduction delays, LBBB) were associated with higher odds of shockable initial rhythm in bystander-witnessed arrests.
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IV magnesium adds little for ED headache
RCT of 1,028 ED patients with acute nontraumatic headache found IV magnesium sulfate plus paracetamol achieved more frequent treatment success (78.9% vs 65.1%) but pain score differences were below clinical importance thresholds, with less rescue analgesia needed but more mild side effects.
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MRI profiles of postanoxic status epilepticus
Two-center study of 192 postanoxic patients using quantitative MRI found postanoxic status epilepticus exhibited more favorable hypoxic-ischemic brain injury profiles (higher whole-brain ADC values) compared with generalized periodic discharges or malignant EEG patterns.
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Few quality indicators for prehospital post-ROSC care
Scoping review identified 16 potential quality indicators for prehospital post-ROSC care across five domains, highlighting a major evidence gap since only two existing studies listed formal indicators.
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Survey protocol: paramedic OHCA reversible causes
Cross-sectional survey protocol will assess paramedic confidence in identifying OHCA reversible causes across Australia, UK and New Zealand, evaluating equipment availability and perceived barriers.
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Whole blood vs components in prehospital trauma
Review compared whole blood versus component therapy for out-of-hospital trauma resuscitation — direct clinical relevance for prehospital blood product protocols.
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Research priorities for prehospital older adult care
Modified Delphi study identified five high-priority research themes for older adult prehospital care, with falls assessment, prevention, and clinician training ranking highest across research and knowledge translation domains.
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Dual defibrillation needs safety frameworks
Commentary argued dual defibrillation safety requires implementation frameworks and training protocols, not just post-use device testing, due to risks of electrical arcing and device damage.
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Post-ROSC signs of life not pre-ROSC prognostic
Letter to Editor argued post-ROSC signs of life should not be used as pre-ROSC prognostic markers, emphasising that clinical signs after ROSC do not predict outcomes during arrest.
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ED intubation success high with videolaryngoscopy
Retrospective study of 1,250 ED intubations showed 93.8% first-pass success with videolaryngoscopy as primary technique, with hypotension and desaturation as most common adverse events.
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Bystander support pathway after OHCA feasibility pilot
Feasibility pilot protocol tested structured support pathway for bystanders involved in OHCA, including digital resources and psychological screening via liaison officers.
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Big shift to online EMS continuing education
Retrospective analysis of 19.3 million CE completions showed post-pandemic shift to online formats, with asynchronous distributive learning increasing 209% and interactive gaming courses increasing 915%.
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Wearables detecting unwitnessed cardiac arrest
Commentary discussed potential survival benefits of wearable-based cardiac arrest detection for unwitnessed arrests, arguing earlier detection could improve response times.
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Endpoint choice in AI coronary triage
Study examined endpoint choice in AI-based coronary triage after cardiac arrest, comparing coronary stenosis versus acute occlusion detection.
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Campus EMS naloxone and harm reduction survey
National survey examined harm reduction programs in collegiate-based EMS agencies, assessing naloxone distribution, overdose response, and substance use support services.