Paramedic PapersHome Daily scans 29 October 2026
Daily scan
Paramedic research, 29 October 2026
A systematic review finds prehospital trauma analgesia safe and effective across the four drug classes Australian crews already carry, and a large US cohort links field undertriage in major trauma to a 19% higher in-hospital mortality risk.
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Trauma analgesia safety confirmed across four drug classes
An Israeli-led systematic review of 17 multinational studies (6 RCTs, 17,115 injured adults) found opioids, ketamine, methoxyflurane and paracetamol all effective for prehospital trauma analgesia, with no drug-attributed serious adverse events reported apart from one opioid study.
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Undertriage in trauma linked with higher in-hospital mortality
A US retrospective cohort of 59,095 injured adults in Pennsylvania found a 53% field undertriage rate, with undertriage associated with a 19% higher relative risk of in-hospital mortality (aRR 1.19) and, for patients over 60, a lower chance of discharge home.
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Prehospital blood linked to arrival hypocalcaemia in trauma
A US prospective multicentre subanalysis of 1,047 trauma patients brought by EMS found calcium derangements on arrival associated with lower survival, with 56.6% of the 136 patients given prehospital blood hypocalcaemic on arrival and 5 hypercalcaemic patients having received prehospital calcium.
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Prehospital SBP ≥180 linked with worse stroke outcomes
A Japanese cohort of 1,106 EMS-transported acute large-vessel-occlusion stroke patients found prehospital SBP ≥180 mmHg associated with lower odds of good 90-day functional outcome (aOR 0.43) compared with SBP <120, with the association significant only in patients treated with endovascular thrombectomy.
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Central venous access during arrest feasible in simulation
A US simulation study in a standard ambulance found central venous cannulation technically feasible during simulated refractory shockable cardiac arrest, completed in all runs with left femoral access identified as the most practical site and ACLS interventions maintained throughout.
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CT stroke unit model separates diagnosis from transport
Japanese authors describe a conceptual EMS-integrated diagnostic-focused mobile stroke unit model that keeps CT diagnosis at the scene or rendezvous point but hands treatment and transport to existing EMS vehicles, aiming to cut cost, staffing and operational complexity.
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In-flight events uncommon in international air repatriation
A Canadian retrospective cohort of 3,905 international fixed-wing air ambulance repatriations (2009–2024) found in-flight events in 26.7% of transports but major events in only 3.9%, with independent predictors including age, trauma and neoplasm diagnoses, oxygen therapy and mechanical ventilation.
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Fatigue common among US helicopter air ambulance pilots
A US survey of 120 helicopter air ambulance pilots across 21 operators found 53% reporting poor sleep quality, 34% admitting to nodding off during a flight, 87% reporting sleep inertia affecting work performance, and fatigue rated worst on the return-to-base leg.
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Flight simulation training: engagement shown, evidence thin
A Norwegian-affiliated systematic review of 7 articles found high-fidelity simulation feasible and engaging for critical care paramedic flight training, but insufficient evidence on whether it improves self-awareness or real prehospital performance.
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New ambulance nurse induction: four challenges, three fixes
A Swedish participatory action research study in one ambulance service identified four challenges in introductory training for newly employed nurses — theory-heavy structure, variable supervision, weak leadership connection and role ambiguity — and translated them into three programme interventions.