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Daily scan
Paramedic research, 19 September 2026
5 new paramedic and prehospital papers from the 19 September 2026 scan.
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DNAR orders missed in OHCA dispatches
One-year regional study of 1,695 lights-and-sirens dispatches for suspected OHCA in Southern Denmark — 15.7% involved a patient with a physician-issued hospital DNAR order that dispatchers and crews couldn't access, one-day mortality was 90.6% in that group, and the authors call for DNAR orders to be visible to emergency dispatch and prehospital providers.
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DNACPR termination policies poorly applied in Japan
Nationwide Japanese survey of 561 fire departments — 47% had a prehospital termination-of-resuscitation policy for OHCA with DNACPR wishes, yet 52% of departments with evaluable data applied it to zero cases during 2024 despite encountering eligible patients, and departments with a policy transported far fewer arrests with ongoing CPR (46% vs 82%).
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Transport destination not linked to OHCA outcomes
Population-based cohort of 12,663 OHCA transports in Nagoya under a dispatch-guided destination system — transport to critical care medical centres showed no association with favourable one-month neurological outcomes overall, was linked to lower one-month survival in non-shockable rhythms (OR 0.66), and only refractory shockable rhythms showed a possible survival edge (19.7% vs 3.3%, imprecise estimate).
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Paediatric IV ketamine sedation very safe
Systematic review of 20 studies covering 67,871 children having IV ketamine procedural sedation in EDs — no deaths or permanent adverse outcomes, sentinel events pooled at about 1 in 11,558 sedations, serious adverse events 0.34%, with age ≥10, upper respiratory infection and opioid co-administration modest predictors while ASA status and benzodiazepine co-administration were not.
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Rising ED boarding for older adults
US national survey analysis of 4.45 million admissions of adults aged ≥65 (2015–2022) — 85% boarded ≥2 hours in the ED, mean boarding time rose from 138 minutes in 2018 to 343 minutes in 2022 and roughly 501 minutes for patients with Alzheimer's-related dementia, with the worst growth in metropolitan areas and among those ≥75.