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Daily scan
Paramedic research, 3 October 2026
15 new paramedic and prehospital papers from the 3 October 2026 scan.
Listen to the 3 October 2026 podcast episode
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Risk-score-guided conveyance safe in chest pain
A Dutch pragmatic RCT testing whether a prehospital risk score could guide ambulance conveyance in 5170 adults with undifferentiated chest pain — it was non-inferior to usual care for 3-day serious adverse events while increasing non-conveyance, cutting 30-day ED presentations and lowering costs.
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Stroke care gaps for First Nations patients
Victorian linked-data study of 32,163 EMS-attended stroke/TIA patients found First Nations patients had more than double the age-standardised incidence of EMS attendance, were less likely to receive a paramedic stroke assessment (58.2% vs 67.3%) and less often taken to thrombectomy-capable hospitals, though adjusted mortality was similar.
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What OHCA care is worth paying for
Systematic review of 10 economic evaluations of prehospital OHCA care found early defibrillation and EMT-delivered ALS, prehospital ECPR, and termination-of-resuscitation rules are all cost-effective, while health-equity reporting across the studies was poor.
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Nearly half of paediatric doses off-protocol
US quality-registry cohort of 386 prehospital paediatric medication administrations found 46.4% deviated at least 20% from protocolised dosing — mostly underdoses — with ondansetron (aOR 36.9) and the intranasal route (aOR 7.3) the biggest drivers.
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Prehospital vasopressors in trauma unproven
Systematic review of five retrospective studies (31,849 trauma patients) found prehospital vasopressor infusions before haemorrhage control showed inconsistent mortality associations — one military study found markedly lower adjusted survival and another linked vasopressors to more massive transfusion and coagulopathy — on very-low-certainty evidence.
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Methoxyflurane feasibility confirmed in Canada
Canadian feasibility study of patient-controlled inhaled methoxyflurane in 97 adult trauma patients found 95% protocol compliance, median pain falling from 8/10 to 5/10, mostly mild side effects in 23%, and no serious drug-related adverse events.
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Bigger crews work faster, don't save more
Korean nationwide cohort of 78,203 severe trauma patients found crews of three or more achieved better prehospital IV access (aOR 1.47) and scene times ≤10 minutes (aOR 1.09) than two-person crews, with no survival difference after adjustment.
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EMS and ED disagree on paediatric asthma signs
Prospective study of 295 children transported with asthma exacerbations found only slight-to-fair agreement between EMS and ED clinicians on asthma severity exam findings, suggesting a prehospital paediatric asthma severity score would be hard to validate.
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Two-thirds of stroke patients delay seeking care
Meta-analysis of 27 studies and 266,336 ischaemic stroke patients across 14 countries found 67.7% experienced prehospital delay before seeking care, with stroke knowledge and symptom recognition the key modifiable drivers.
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Direct geriatric admission depends on geography
Swedish register study of 8208 ambulance-transported patients aged ≥65 in Stockholm found only 7% went directly to a geriatric unit instead of an ED, with conveyance rates varying fourfold (4–21%) between hospital service areas and largely explained by distance, ownership and staffed-bed numbers.
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US racial gaps in trauma interventions
US trauma–EMS linked cohort of 18,280 injured adults found Black patients received fewer prehospital airway interventions and intubations than White patients, and patients from disadvantaged neighbourhoods received fewer prehospital interventions overall.
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Trauma analgesia rarely given prehospital
A Turkish review of 506 trauma patients found prehospital analgesia was given to only 1%, with 77.5% of surveyed paramedics saying they withheld it for fear of interfering with the hospital doctor's examination.
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Prehospital STEMI data transmission speeds reperfusion
In 409 Chinese STEMI patients, prehospital WeChat transmission of patient data to the PCI centre shortened symptom-to-first-medical-contact (75 vs 120 minutes), door-to-balloon (50 vs 67 minutes) and total ischaemic time (121.5 vs 150 minutes).
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What paramedics want from voice-to-text ePCRs
A mixed-methods survey of 323 Canadian paramedics plus 14 interviews identified and ranked the features paramedics want in speech-recognition documentation — 86% viewed it positively, with accuracy, patient interaction and compliance rated most important.
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Violence-related EMS calls: who actually dies
A retrospective registry review of 29,335 violence-related EMS encounters in Istanbul found confirmed prehospital death in only 0.45%, most strongly associated with severe respiratory compromise (aOR 56), altered consciousness (aOR 10.7) and cyanosis (aOR 4.2).