Exploring the impact of road-based intensive care paramedic crewing configurations in Anglo-American paramedic systems: A scoping review.
Australasian emergency care · 2025-10-18 · Scoping review
Abstract
OBJECTIVES: This scoping review investigates Intensive Care Paramedic (ICP) crewing configurations within road-based Anglo-American paramedic systems, aiming to map and describe the existing literature and guide future research. METHODS: Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive database and grey literature search was conducted up to May 2025. RESULTS: The search yielded 3442 articles, of which 19 met inclusion criteria. Four categories emerged: patient outcomes, operational outcomes, provider experiences, and clinical performance. Most studies focused narrowly on OHCA, with limited attention to other patient outcomes. Operational outcomes emphasized response times and on-scene intervals; provider experiences highlighted professional isolation and limited support. Clinical performance centered on error rates, time to intervention, and deviations from guidelines. CONCLUSIONS: This synthesis indicates that literature on ICP crewing has traditionally focused on OHCA, and ICPs may be associated with improved outcomes in this cohort. The literature inferred tiered response models may facilitate faster response intervals. ICPs working in Professionally Autonomous systems operating within single-response structures report feelings of professional isolation, and dual ICP crews are not consistently linked to enhanced clinical performance. Future research should investigate ICP crewing configurations within the context of tailored healthcare frameworks, prioritizing meaningful outcome measures that optimize patient care, provider experiences, and operational efficiency.