Decision-making by ambulance clinicians in London when managing patients with epilepsy: a qualitative study
| Autor: | Leone Ridsdale, Lisa Burrell, Adam J. Noble |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
Ambulances Decision Making MEDLINE Guidelines as Topic Critical Care and Intensive Care Medicine Interviews as Topic Epilepsy Patient safety Professional Competence London medicine Humans Qualitative Research Health Services Needs and Demand business.industry Patient choice Health services research Attendance General Medicine medicine.disease Triage Emergency Medical Technicians Emergency Medicine Female Medical emergency business Qualitative research |
| Zdroj: | Emergency Medicine Journal. 30:236-240 |
| ISSN: | 1472-0213 1472-0205 |
| DOI: | 10.1136/emermed-2011-200388 |
| Popis: | Background In the UK, epilepsy is the neurological condition with the highest rate of accident and emergency department re-attendance, with most arriving by ambulance. Ambulance clinicians triage patients and assess their need for attendance. This study examined the decision-making process of ambulance clinicians in these situations. Methods In-depth interviews with 15 ambulance clinicians working in South London. Results Interviewees identified that epileptic seizures that self-resolve present a triage challenge. They reported insufficient training and guidance available for these situations and substantial reliance on experience to direct their practice. Fears of litigation in the event of complications, pressures of public expectation and limited on-scene access to relevant patient information or appropriate alternative care pathways were reported to be significant factors influencing decisions for care for epilepsy seizures. Discussion Ambulance clinicians reported negotiating a balance between patient safety and patient choice, when deciding whether to transport a patient with epilepsy to hospital or not. Clinician fears and the pressures and limitations of practice may result in hospital conveyance being used as a safety precaution in some instances. Conclusions Decisions regarding conveyance of patients with epilepsy in this study were substantially guided by ambulance clinician experience rather than by robust training and guidelines. This study supports the need for improved guidance that addresses this common area of practice and the development of alternative care pathways that may be used by ambulance clinicians for patients with epilepsy. |
| Databáze: | OpenAIRE |
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