PREHOSPITAL CARE

The emerging role of the emergency care practitioner

S Cooper, B Barrett, S Black, C Evans, C Real, S Williams, B Wright

Westcountry Ambulance Service NHS Trust, UK

Correspondence to:
Correspondence to:
Dr S Cooper
Faculty of Health and Social Work, C403 Portland Square, University of Plymouth, Plymouth, Devon PL4 8AA, UK; simon.cooper{at}plymouth.ac.uk

Objectives: To examine the emerging role of the emergency care practitioner (ECP) with comparisons to paramedic practice. Key activities were identified of newly appointed ECPs using qualitative methodology and a qualitative and quantitative comparison of patient treatment was made.

Method: A constructivist methodology taking account of stakeholder input and drawing upon the constant comparisons of different group’s construction of reality. Four practitioners completed reflective patient case studies and adapted patient report forms, which were compared with a second case group of 11 paramedics. In addition individual and focus groups interviews were performed with key stakeholders.

Results: In the comparison between ECP and paramedic roles, 331 paramedic incidents were compared with 170 ECP reports. ECPs treated 28% of patients on scene compared with 18% by paramedics (p = 0.007). Fifty per cent of ECPs patients were conveyed compared with 64% of paramedics (p = 0.000). Analysis of the 269 reflective reports and 14 stakeholder interviews revealed four key themes. Firstly, ECPs had a beneficial impact on the deployment of resources, especially relating to non-conveyance. Secondly, their training and education improved their decision making repertoire and developed their confidence for a leadership role. Thirdly, inter-agency collaboration and cooperation was improved, and finally, care benefits were increased especially relating to immediacy of treatment and referral mechanisms.

Conclusions: The results indicate that an investment in the ECP role could be beneficial, however, more work is required to evaluate the development of practice, the quality of care, and cost benefits.

Abbreviations: ECP, emergency care practitioner; EMS, emergency medical system; MIU, minor injury unit; PTS, patient transport system; RRV, rapid response vehicle; RITA, rapid intervention, treatment, and assessment; UTV, urgent transport vehicle

Keywords: emergency care practitioners; paramedic practitioners

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eLetters:

Read all eLetters

Emergency Care Practitioners should not be compared with paramedics

Suzanne Mason

EMJ Online, 4 Jan 2005 [Full text]

There is a lack of other professionals for ECPs to be compared with

Mark J Bilby

EMJ Online, 26 Apr 2005 [Full text]

Author's Reply: Emerging role comparisons

Simon J Cooper

EMJ Online, 19 Oct 2005 [Full text]