Table 1 Characteristics of quantitative and qualitative included studies (n = 65)
1st author (Year) Country [ref] | Design | Methods/Data sources | Patients (n) | Professionals (n) |
|---|---|---|---|---|
Alicandro (1995) USA [29] | Pre-test post-test | Data card, Online database | Patients (n = 361) who refused conveyance | Not described |
Alrazeeni (2016) Saudi Arabia [31] | Retrospective, observational | Patient care reports | Patients (n = 1791) who were not conveyed | EMTs |
Anderson (2002) Denmark [32] | Retrospective, observational | Prehospital database, National Patient Register, Central Personal registry, Registry of Causes of Death | Patients (n = 1187) with hypoglycaemia | MICU physicians |
Burstein (1996) USA [56] | Prospective, cohort | Identifying card, Telephone follow-up | Patients (n = 361) who refused medical assistance | Emergency physicians (n = 22), ALS and BLS providers |
Burstein (1998) USA [57] | Prospective, observational | 10-point assertiveness scale, ED disposition instrument | Patients (n = 130) who refused medical assistance | Paramedic medical-control console operators, EMS-crews, Emergency physicians |
Burrell (2013) UK [82] | Qualitative | Topic guided in-depth interviews | No patient population included | EMT level 2 (n = 1), EMT level (n = 4), Paramedics (n = 5), Paramedic team leaders (n = 4), Emergency care practitioner (n = 1) |
Cain (2003) USA [58] | Prospective, observational | Patient care report, Refusal form | Ambulance calls (n = 17,416) | Basic & advanced paramedics |
Carter (2002) Canada [59] | Prospective, observational | Telephone calls, Ambulance call reports | Patients (n = 100) with hypoglycaemia receiving IV dextrose | Paramedics, Emergency medicine senior residents |
Chen (1996) Taiwan [60] | Prospective, observational | Dispatch record, Ambulance run record, ED disposition form | Patients (n = 1035) who called an ambulance | EMTs |
Cone (1995) USA [8] | Retrospective, observational | Emergency department records, Telephone follow-up, Ambulance call reports, Medical command control forms | Patients (n = 85) who refused conveyance | Paramedics, Volunteer municipal basic life support units |
Deasy (2008) Ireland [61] | Prospective observational | Data sheets | Ambulance calls (n = 263) | Emergency Medicine Specialists, Paramedics |
Ebrahimian (2014) Iran [83] | Qualitative | Semi-structured interviews | No patient population included | EMS staffs (n = 18) |
Gerlacher (2001) USA [79] | Cross-sectional | Patient records | Patients (n = 15,409) ≤ 12 years | First responder firefighters, EMTs, Paramedics |
Goldstein (2015) Canada [33] | Retrospective, observational | Electronic patient care records | Patients (n = 63,067) ≥ 65 years | Primary care paramedics, Intermediate care paramedics, Advanced care paramedics |
Haines (2006) USA [62] | Prospective, observational | Telephone follow-up questionnaire, Ambulance records | Patients (n = 5336) <21 years | ALS-paramedics, Physicians |
Halter (2011) UK [84] | Qualitative | Semi-structured interviews | No patient population included | EMTs, Paramedics (n = 12) |
Hipskind (1997) USA [63] | Prospective, observational | Ambulance run reports | Patients (n = 683) who refused conveyance | Paramedics (n ≈ 350) |
Højfeld (2014) Denmark [34] | Retrospective, observational | MECU database, Medical records | Mobile emergency care unit runs (n = 15,392) | Anaesthesiologists |
Jensen (2013) Canada [64] | Prospective, observational | Data from emergency health services, Patient care records, Databases | Ambulance calls (n = 265) for long term care facility patient | Extended care paramedics (n = 7), Paramedics |
Kahalé (2006) Canada [65] | Prospective, observational | Ambulance call reports, Hospital charts, Telephone interviews | Patients (n = 345) <16 years | EMTs, Paramedics |
Kamper (2001) USA [35] | Retrospective, observational | Ambulance run records, ED records, Hospital records | Ambulance calls (n = 53,627) | Paramedics |
Kannikeswaran (2007) USA [36] | Retrospective, observational | Standardized data extraction sheets | Ambulance runs (n = 5976) for children <18 years | EMT-Ps, EMT-Bs |
Keene (2015) Australia [85] | Mixed-methods | Structured interviews, Patient care records | Patients (n = 33,333) where an ambulance was dispatched | Ambulance paramedics, Intensive care paramedics |
Key (2003) USA [30] | Pre-test post-test | Patient/ambulance records | Ambulance calls (n = 11,488) | Paramedics, EMTs |
Knight (2003) USA [37] | Retrospective, descriptive | State-wide EMS data, State-wide ED data, Death certificate data | EMS dispatches (n = 277,221) | Not described |
Lerner (2003) USA [66] | Prospective, observational | Telephone interviews | Patients (n = 36) with hypoglycaemia | EMT-Ps (n = 23) |
Magnusson (2016) Sweden [38] | Retrospective, observational | Patient notes | Patients (n = 529) with low priority, uncertain need for ambulance and vague symptoms | Ambulance nurses |
Marks (2002) UK [9] | Retrospective, observational | Patient report forms | Patients (n = 500) not conveyed | EMTs, Paramedics |
Mechem (1998) USA [67] | Prospective, observational | Telephone interviews | Ambulance calls (n = 115,135) | Nurses, Paramedics |
Minhas (2015) Canada [39] | Retrospective, cohort | EMS patient records, ED patient records | Patients (n = 286) 18–65 years with supraventricular tachycardia | ALS paramedics |
Moss (1998) USA [40] | Retrospective, observational | Prehospital records | EMS responses (n = 6512) | Paramedics |
Murphy-Jones (2016) UK [86] | qualitative, phenomenological | Semi-structured interviews | No patient population included | Paramedics (n = 6) |
Newton (2015) South-Africa [68] | Prospective, observational | Computerized dispatch logs, Patient report forms | Ambulance calls (n = 1689) | BLS emergency care providers, ILS emergency care providers, ALS emergency care providers |
O’Hara (2015) UK [87] | Qualitative | Reviewing relevant national and local documents (Reports, policies, protocols), Semi-structured interviews, Observations, Digital diaries, Informal interviews, Focus groups, Written notes | No patient population included | Directors, Managers, Specialist paramedics, Paramedics, Emergency care assistants/technicians/support workers |
Persse (2002) USA [69] | Prospective, observational | Patient care records, Structured telephone interviews | Patients (n = 2207) ≥ 65 years | Paramedics, EMTs |
Peyravi (2013) Iran [41] | Retrospective, observational | National data registry, Ambulance station data registry | Ambulance runs (n = 84,084) | Nurses, Paramedics, GPs |
Peyravi (2015) Iran [42] | Retrospective observational | Patient care records, Telephone interviews | Ambulance runs (n = 81,999) | Not described |
Porter (2007) UK [88] | Qualitative | Focus groups (n = 3) | No patient population included | Paramedics (n = 25) |
Pringle (2005) USA [43] | Retrospective, observational | EMS reports, Telephone interviews | EMS patient encounters (n = 1894) | EMT-Bs, Paramedics |
Rudolph (2011) Denmark [44] | retrospective, observational | Medical emergency care unit database, Autopsy reports | Patients (n = 4762) with acute opioid overdose | Anaesthesiology specialists, ALS providers |
Schmidt (2001) USA [70] | Prospective, observational | Patient records | Patients (n = 1433) were an ambulance was dispatched | EMT-Ps, EMT-ILSs, EMT-Bs |
Schmidt (1998) USA [71] | Prospective, observational | Structured telephone interview | Patients (n = 324) who refused conveyance | Paramedics |
Schmidt (2000) USA [72] | Prospective observational | Data sheets | Patients (n = 1433) where an ambulance was dispatched | EMT-Ps, EMT-ILSs, EMT-Bs |
Schmidt (2006) USA [45] | retrospective, observational | EMS database | Ambulance runs (n = 1501) | Paramedics |
Selden (1990) USA [46] | Retrospective, observational | Run records | Ambulance runs (n = 11,780) | Paramedics |
Seltzer (2001) USA [47] | Retrospective, observational | Run records, Structured telephone interviews | Patients (n = 89) <18 years who refused conveyance against medical advice | EMT-Ds, EMT-Ps |
Shaw (2006) UK [81] | Mixed methods | Patient records | Ambulance runs (n = 76,635) | Paramedics, EMTs |
Simpson (2014a) Australia [74] | Prospective, cohort | Data sheets, Administrative databases | Patients (n = 1610) ≥65 years who have fallen | Paramedics |
Simpson (2014b) Australia [73] | Prospective, cohort | Data collection tool, Dispatch system | Patients (n = 1610) ≥65 years who have fallen | Paramedics (n = 384) |
Snooks (2005) UK [89] | Qualitative | Focus groups | No patient population included | Paramedics (n = 26) |
Snooks (2014) UK [27] | CRCT | Paramedic records, ED records | Patients (n = 779) ≥65 years who have fallen | Paramedics (n = 42) |
Snooks (2004a) UK [28] | Quasi-experimental | Patient report forms, ED records, GP records, Questionnaire | Patients (n = 797) were an ambulance was dispatched | Paramedics (n = 5), EMTs (n = 5) |
Socransky (1998) USA [48] | Retrospective, observational | Patient records, Hospital records | Ambulance runs (n = 10,888) | Paramedics |
Stark (1990) USA [49] | Retrospective, observational | EMS database | Ambulance calls (n = 1715) | Paramedics, Physicians |
Staudenmayer (2012) USA [50] | Retrospective, cohort | Population-based injury database | Patients (n = 69,413) with a primary diagnosis of ‘injury’ or ‘trauma’ | Not described |
Strote (2008) USA [75] | Prospective, cohort | Medical incident report forms, Telephone interviews | Patients (n = 2359) with hypoglycaemia | EMTs, Paramedics |
Stuhlmiller (2005) USA [51] | Retrospective, observational | On-line medical command audio tapes, Patient run sheets, Non-conveyance sheets | On-line medical control calls (n = 137) for patient-initiated refusals | Paramedics |
Tiedemann (2013) Australia [76] | Prospective, cohort | Patient records, Questionnaires (e-mail) | Patients (n = 2842) ≥70 years who have fallen | Paramedics |
Tohira (2016a) Australia [53] | Retrospective cohort | Patient care records, ED information system, Death registry | Patients (n = 1238) post-ictal or with hypoglycaemia | Paramedics |
Tohira (2016b) Australia [52] | Retrospective, cohort | Patient care records, ED information system, Death registry | Patients (n = 127,574) were an ambulance was dispatched | Paramedics |
Van der Pols (2011) Netherlands [77] | Prospective, cohort | Patient record, Hospital databases, Dispatch centre database | Patients (n = 1842) were an ambulance was dispatched | Ambulance nurses |
Vilke (1999) USA [54] | Retrospective, observational | Prehospital database, Death registry | Patients (n = 94,466) were an ambulance was dispatched | Paramedics |
Vilke (2002) USA [78] | Prospective, observational | Telephone interviews | Patients (n = 636) ≥ 65 years and who signed out against medical advise | EMTs, EMT-Ps, EMT-Ds |
Zachariah (1992) USA [55] | Retrospective, observational | Patient records, Structured telephone interviews | Patients (n = 158) not conveyed | Paramedics |
Zorab (2015) UK [80] | Cross-sectional | Questionnaires | No patient population included | Emergency Care Assistants, Ambulance Technicians, Student Paramedics, Paramedics, Emergency Care Practitioners, Critical Care Paramedics |