Jul 11, 2023

Palliative care paramedics could help keep patients out of our EDs

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The role of paramedics is becoming increasingly recognised to be well placed to deliver out-of-hours unscheduled palliative care. [Source: Care Search]

As the need for home-based and out-of-hours palliative care continues to grow, those in the sector are still figuring out the best way to address these needs. Many accessing palliative care prefer to access care at home, putting more focus on community and social services. 

New data from the Australian Institute of Health and Welfare (AIHW) shows that palliative care hospitalisations continue to increase faster than all hospitalisations – a 23% increase compared with a 12% overall increase over the five years up to 2020-21. 

Until recently, paramedics were known to mainly provide life-saving care but as an increasing number of older people experience chronic illnesses that offer a variety of potential complications, paramedics are faced with making decisions about care and treatment that are not black and white.

But there is not a lot of research on how paramedics contribute to palliative care from the point of view of patients and families. 

To address this, the South Australia Ambulance Service (SAAS) created and studied the impact of their Extended Care Paramedics (ECP) group – consisting of Intensive Care paramedics who have specialised palliative care training and strong partnerships with local specialist palliative care services. 

The study found that families saw ECPs as an extension of the palliative care team and expressed how important it was to have a timely yet skilled and person-centred response to their immediate needs and concerns. 

Exacerbated by the ageing of Australia’s population, the Aged Care Quality and Safety Commission advised the aged care sector to put palliative care initiatives and improvements at the top of the priority list, especially for older people in residential aged care. 

The latest 2023-2024 Australian Budget made significant investments in strengthening primary health and aged care which industry stakeholders hope to see benefits from in future AIHW data.

“There is a great deal of positive and much-anticipated reform in aged care, but because the changes are so recent, we are waiting for data showing what we hope is increasing access to palliative care for aged care residents,”  said PCA’s Chief Executive Officer (CEO), Camilla Rowland.

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  1. How can a Paramedic make automatous decisions that can result in the death of a patient?
    How do you protect the clinician from prosecution from the health regulator if the patient dies and a family member makes a complaint?
    Look at the recent case of Dr Teo?
    As Paramedics we are judged to have caused harm if we haven’t delegated the responsibility to a Medical Officer.

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