Fractured care? Exploring Australian paramedics’ approach to neck of femur fractures – a cross-sectional survey
Trauma (SAGE) · 2025-06-26 · Observational study
Abstract
Introduction Neck of femur (NOF) fractures are a common injury, particularly in older patients. Pre-hospital treatment guidelines are largely absent, and little is known about how Australian paramedics manage this potentially life-threatening injury. This study aims to garner insights on pre-hospital care that may inform paramedic practice, education, and policy for the pre-hospital treatment of suspected NOF fractures. Methods A purpose designed anonymous online cross-sectional survey was developed and administered to Australian paramedics using Qualtrics software. Demographic data including education and training, along with confidence, beliefs, and behaviours related to immobilisation techniques, pain management strategies, cognitive assessment tools, and transport decisions were collected. Results From 258 completed responses available for analysis an apparent lack of education and training specific to NOF fracture care, and the absence of dedicated guidelines were observed. Respondents lacked confidence in both fracture assessment and management and reported mixed views regarding the perceived importance of key treatment priorities. There was also considerable variability in fracture immobilisation methods, with no clear consensus reached on the best approach. While standard pain management techniques were widely accepted, alternative methods, such as cold therapies showed notable heterogeneity. Conclusion The management of NOF fractures by Australian paramedics varies, influenced by differences in clinical confidence, underlying beliefs, and practice behaviours. This highlights the need for clear, evidence-based guidelines and education to standardise paramedic practice. Addressing the gaps in education and protocol development could enhance paramedic confidence, ensure more consistent care, and improve patient outcomes.
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Tags
Splinting & reduction · Paramedics & EMTs
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