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Paramedic treat-and-discharge rarely used but efficient

Utilization and Metrics Associated with Paramedic Treat and Discharge Medical Directives for Paramedic Services and Emergency Departments: A Retrospective Cohort Study
Prehospital Emergency Care · Added 11 May 2026

This retrospective cohort study analysed paramedic treat and discharge medical directives to understand utilisation patterns and key metrics for prehospital and emergency department decision-making — the findings provide valuable insights into the scope, safety, and operational impact of treat-and-refer pathways.

Study type

Cohort

Design

Retrospective cohort of paramedic records

Participants

1,596 patients potentially eligible for discharge directives (Ontario, Canada)

Main finding

Of 1,596 eligible patients, 68.0% were transported, 29.7% refused transport and only 2.2% (35) were discharged by paramedics; discharged patients had half the median call duration (45 vs 87 min); among 494 linked ED patients, mean ED length of stay was 6 h 20 min and 70.2% were discharged from ED.

Caveat

Descriptive single-region cohort; safety and system-level impact not assessed

Bottom line

Context only

Learning goal

Understand how paramedic treat-and-discharge pathways affect call duration and emergency department demand in Australian practice.

More

• Topic: Operations & systems
• Daily scan: 11 May 2026

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