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Daily scan
Paramedic research, 4 November 2026
8 new paramedic and prehospital papers from the 4 November 2026 scan.
Listen to the 4 November 2026 podcast episode
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What helps kids in pain in ambulances
A UK realist evaluation across three English ambulance services and two children's EDs — 44 interview transcripts plus 34,068 clinical records — refined the programme theory for paediatric pain care, with clinician preparedness and compassionate person-centred care emerging as the key mechanisms.
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M-DIRECT stroke triage scale revalidated
A Spanish prospective study of 1,950 prehospital code-stroke patients revalidated the M-DIRECT scale five years after implementation, showing 77% sensitivity and 76% specificity for identifying endovascular-treatment candidates, with a positive score more than tripling the odds of EVT.
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Post-ROSC ST elevation tracks acute coronary occlusion
A Japanese single-centre review of 149 angiography-evaluable OHCA survivors with presumed culprit lesions found post-resuscitation ST-segment elevation marked an acute occlusive coronary phenotype but was not independently linked to neurological outcome once prehospital factors were accounted for.
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Two-thirds of ECPR survivors alive at five years
A US–Czech retrospective cohort of 728 patients given ECPR for refractory VT/VF OHCA found 29% survived to hospital discharge and, among those survivors, about two-thirds were still alive at five years with favourable cerebral performance in most.
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STEMI deaths now mostly prehospital
A US Circulation viewpoint argues that because most STEMI deaths now occur out of hospital, the biggest gains lie in shortening symptom-onset-to-reperfusion, and sets out five recommendations spanning patient education, prehospital pharmaceuticals and reimbursement reform.
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Long wildfire shifts linked to broken sleep
A US survey of 90 first responders during the 2025 Los Angeles wildfires found 24-hour shifts were associated with 1.65 fewer total sleep hours and four or more consecutive shifts with shorter sleep, with 83% reporting poor or very poor sleep quality.
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Turning HEMS debriefs into shared learning
Focus groups with 30 HEMS clinicians found a quality improvement project capturing routine debriefs ('Coffee and Cases') strengthened organisational learning through three themes: education, accessibility and calibration of learning points.
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US Medicaid cuts threaten EMS funding
A US Health Affairs commentary warns that H.R. 1 and subsequent Centers for Medicare and Medicaid Services rules will deepen financial strain on local EMS systems already struggling with inadequate reimbursement.