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Learning about behavioural emergencies: an evaluation of paramedic textbooks

02 December 2017
Volume 7 · Issue 3

Abstract

Background:

Individuals with behavioural emergencies (mental health or substance-use crises) are being seen more frequently in emergency departments. Therefore, emergency medical service (EMS) providers are increasingly being called upon to respond to such cases. However, research in paramedic education on this topic is limited.

Problem:

Very little is known about the quality of EMS provider training in this field. While the National EMS Education Standards Instructional Guidelines (NEMSES-IG) outlines a curriculum, no research has examined the textbooks commonly used to cover this.

Research question:

To what extent do paramedic textbooks include content outlined by the United States (US) NEMSES-IG on the management of behavioural emergencies?

Methods:

The current study surveyed the textbooks for 305 accredited paramedic training programmes in the US, identifying the 5 most common texts. The textbooks' content was compared by two trained coders against the NEMSES-IG.

Results:

Findings revealed that the textbooks did not fully cover the components of the NEMSES-IG. Of the five textbooks, chapters on behavioural emergencies varied from covering between 55% and 74% of the educational standards.

Conclusions:

This study reveals that many of the textbooks are lacking in the area of behavioural emergency management. It highlights the need to improve paramedic education with a greater focus on evidence-based management practices.

In the emergency medical services (EMS), paramedics and emergency medical technicians (EMTs) or similar are often called upon to respond to behavioural emergencies.

In the United States (US), mental and behavioural health conditions affect approximately 57 million adults (National Highway Traffic Safety Administration (NHTSA), 1998). The American Psychiatric Association defines a behavioural emergency as:

‘an acute disturbance of thought, mood, behaviour, or social relationship that requires immediate intervention as defined by the patient, family or the community’

(Allen et al, 2002).

(Allen et al, 2002).

Within the context of paramedicine, behavioural emergencies are defined by the NHTSA as covering a broad range of behavioural and psychiatric disorders characterised by abnormal and maladaptive behaviour, which may result in a disturbance in normal functioning, caused by emotional or physiological conditions, leading to undesirable consequences (NHTSA, 1998). Behavioural emergencies have also been referred to as psychiatric emergencies, although the former is the preferred term among EMS (Tucci et al, 2015).

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