Paramedic research, 15 September 2026

8 new paramedic and prehospital papers from the 15 September 2026 scan.

Gelatin and HES impair clot formation ex vivo

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · Simulation · Hypothesis-generating

Ex vivo human whole-blood model testing graded dilution with gelatin 4%, HES 130/0.42 and a balanced crystalloid — both colloids produced a clearly hypocoagulable ROTEM profile (prolonged clotting and clot formation times, reduced alpha-angle and maximum clot firmness, worst with HES) while the crystalloid alone stayed haemostatically neutral, and combining crystalloid with colloid dilution worsened the coagulopathy further.
CPR quality maintained across paramedic-to-ED handover

Prehospital Emergency Care · Cohort · Context only

Observational study of 35 OHCA transfers tracking CPR quality across the paramedic-to-ED handover — chest compression fraction (89–92%) and rate stayed guideline-compliant in every interval with no deterioration at transition, though compression depth was significantly deeper during paramedic intervals.
HFNO reduces intubation vs conventional oxygen

Emergency Medicine Australasia · Systematic review · Supports current practice

Systematic review and meta-analysis of 17 RCTs (1,955 patients) comparing high-flow nasal oxygen with conventional oxygen and NIV for acute respiratory failure in the ED — HFNO reduced intubation versus conventional oxygen (RR 0.61) but not versus NIV, with no clear benefit over either in COPD or acute heart failure.
Knowledge gaps in local anaesthetic dosing and LAST

Emergency Medicine Australasia · Cross-sectional · Hypothesis-generating

Multicentre survey of 114 emergency clinicians across three Queensland EDs — fewer than half correctly identified the recommended maximum dose for any of four local anaesthetics, 21.9% couldn't recall any features of LAST, and only 10.5% could state the lipid emulsion dosing regimen.
Fatal illicit drug toxicity: mostly polysubstance OHCA

Emergency Medicine Australasia · Case series · Context only

Case series of 46 deaths in Victoria's EDNAV toxicosurveillance registry (2020–2025) — 67% had out-of-hospital cardiac arrest, 91% were polysubstance with mixed stimulant–sedative patterns most common (methamphetamine 54%, heroin 52%), and hypoxic brain injury was the most frequent terminal complication.
Embedded low-acuity pathway improves rural ED performance

Emergency Medicine Australasia · Cohort · Hypothesis-generating

Quasi-experimental study of an embedded ultra-low acuity pathway at Dubbo Base Hospital (n=4,798) — pathway availability halved did-not-wait rates (14.2%→6.9%), lifted seen-on-time and treatment performance, and cut mean ED length of stay by 51.7 minutes.
Frostbite depth and extent predict amputation

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · Cohort · Context only

Retrospective cohort of 128 frostbite admissions in eastern Turkey — injury depth drove amputation risk (81.5% of third-degree injuries required amputation vs 1.6% of first/second-degree), and combining degree with %TBSA predicted amputation at admission (AUC 0.948), while inflammatory markers added nothing after adjustment.
Delphi consensus on paediatric procedural sedation

Emergency Medicine Australasia · Guideline / statement · Context only

Two-round Delphi consensus of 28 paediatric emergency clinicians from 23 Spanish centres — strong agreement on monitoring standards, staffing and safety requirements for paediatric procedural sedation, with ketamine the preferred agent for painful procedures.