Preplanned participation of paramedics in end-of-life care at home: A retrospective cohort study.
Palliative Medicine · 2020-12-18 · Observational study
Abstract
BACKGROUND: Paramedics commonly face acute crises of patients in palliative care, but their involvement in end-of-life care is not planned systematically. AIM: To evaluate a protocol for end-of-life care at home including pre-planned integration of paramedics and end-of-life care wards. DESIGN: Paramedic visits to patients in end-of-life care protocol were retrospectively studied. SETTING/PARTICIPANTS: All of the patients who had registered for the protocol between 1 March 2015 and 28 February 2017 in North Karelia, Finland, were included in this study. RESULTS: A total of 256 patients were registered for the protocol and 306 visits by paramedic were needed. A need for symptom control (38%) and transportation (29%) were the most common reasons for a visit. Paramedics visited 43% and 70% of the patients in areas with and without 24/7 palliative home care services, respectively (p < 0.001); while 58% of all the visits were done outside of office hours. Problems were resolved at home in 31% of the visits. The patient was transferred to a pre-planned end-of-life care ward and to an emergency department in 48% and 16% of the cases, respectively. More patients died in end-of-life care wards in areas without (54%) than with (33%) 24/7 home care services (p = 0.001). CONCLUSIONS: Integration of paramedics into end-of-life care at home is reasonable especially in rural areas without 24/7 palliative care services and outside of office hours. The majority of patients can be managed at home or with the help of an end-of-life care ward without an emergency visit.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Advance directives & DNR · Older adults · Paramedics & EMTs · Rural & remote
Related articles
- Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis. (Palliat Med, 2022)
- Withholding and withdrawing life-support in adults in emergency care: joint position paper from the French Intensive Care Society and French Society of Emergency Medicine. (Ann Intensive Care, 2019)
- [Palliative care and end-of-life patients in emergency situations. Recommendations on optimization of out-patient care]. (Anaesthesist, 2011)
- Paramedics' Perceptions and Experiences Providing End-of-Life Care: A Cross-Sectional Survey. (Healthcare (Basel), 2026)
- End-of-life emergency medical service transport among patients with terminal cancer by cardiopulmonary arrest status: A nationwide mortality follow-back survey. (Support Care Cancer, 2026)
- Paramedics providing end-of-life care: an online survey of practice and experiences. (BMC Palliat Care, 2024)