Paramedics can provide an effective alternative to standard ambulance service in the...( Paramedics with extended skills can ...),Health

Paramedics with extended skills can provide a safe and effective alternative to standard ambulance transfer and hospital treatment for older people with a minor injury or illness, finds a study published on bmj.com today.

Older people make up to 21% of visits to hospital emergency departments and previous studies have suggested that paramedics can be trained to manage certain conditions in the community. But current research evidence concerning safety, effectiveness and costs to support these changes in practice is lacking.

So researchers based in South Yorkshire carried out the first randomised trial to evaluate the effectiveness of an alternative approach to managing older people with minor problems.

They selected seven experienced paramedics who had completed the Paramedic Practitioner in Older Peoples Support (PPOPS) training course. This scheme aims to deliver patient centred care to older people calling the emergency services with conditions judged to be not immediately life threatening.

The trial took place in Sheffield from September 2003 to September 2004 and included 3,018 patients aged 60 years and above calling the emergency services between 0800-2000hrs with a complaint that fell within the scope of practice of the paramedic practitioners. These included falls, lacerations, nosebleeds or minor burns.

During each week, a paramedic practitioner based in the ambulance control room identified eligible calls and notified either a paramedic practitioner in the community (intervention weeks) or in the emergency department for the standard 999 service (control weeks).

Emergency department attendance or hospital admission between 0 and 28 days was recorded, as was interval from time of call to time of discharge. Patient satisfaction with the service they had received was also measured using a postal questionnaire 3 and 28 days after the incident.

Patients in the inte
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