Volume 9 Issue 3

Moral injury in paramedicine

World Mental Health Day took place on 10th October 2019. In this issue's comment, Esther Murray discusses the concept of moral injury and why it is becoming increasingly relevant to the modern-day paramedic.

Improving the quality and transparency of prehospital case reports using CARE

Clinical case reports play an important role in supporting evidence-based paramedicine. When research on a topic is limited and there is no robust evidence, a case report may be the best available, especially for rare or unusual presentations or in novel clinical practice. Case reports in paramedicine journals are common. However, adherence to the published consensus-based reporting guideline is rare, which may weaken the evidence arising from this body of case report literature. There is a need for greater awareness of the structured reporting guideline for case reports, and for the development of a paramedicine-specific extension. The objectives of this paper are to: describe the current state of case reports in paramedicine; promote the adoption of an internationally accepted, consensus-based reporting guideline; and propose an extension to that guideline, adapted to the unique characteristics of prehospital practice.

Triage systems around the world: a historical evolution

The process of triaging patients has come a long way. Stemming from the battlefield, it is the ability to sort casualties on the severity of their injuries that has improved the allocation of resources. In modern emergency centres, there is a constant struggle to balance limited resources against the ever-growing patient need. Since the late 1980s, when triage became the mainstream standard for sorting patients, many different systems have developed throughout the world. There was a rise in triage system design as emergency centres became more streamlined and resource-conscious. Countries around the world sought to develop triage systems that would be most effective in their given setting—giving rise to multiple variations of the triage process. This narrative review will explore the evolution of triage systems around the world by presenting: a historical perspective, how and where modern systems developed, what the main characteristics are of different systems, and a discussion of the current state of triage system evolution.

Acceptability and effectiveness of a 3D virtual reality cardiovascular lesson

Introduction: The aim is to describe a preliminary pilot incorporating 3D virtual reality (VR) into a cardiovascular problem-based learning (PBL) lesson. Methods: A paramedic cohort of students (<i>n</i>=19) took part in a 12-lesson anatomy and physiology module. Multiple choice question results from the cardiovascular PBL lesson were compared with the multiple choice question results from other organ system PBL lessons. In addition, a questionnaire was answered by 15 students assessing acceptability of the lesson. Results: The authors found that when students used VR materials, they achieved significantly better results compared with the non-VR lessons. Over 80% of students thought that VR-based PBL exercises brought the cardiovascular anatomy to life and was a useful learning tool. Conclusion: The use of VR in a PBL learning environment has a significant positive effect on the performance of the students and is valued by students as useful. It may therefore be beneficial to integrate VR-based learning into emergency medicine training.