FROM GREEN TUNIC TO GREEN TROUSERS Joe Mooney Advanced Paramedic National Ambulance service Multidisciplinary Study day Thursday 26th September 2019 Twitter josephmooney National Ambulance Service ID: 935799
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The Role of theEmergency Ambulance Service for Palliative Care Patients
FROM GREEN TUNIC TO GREEN TROUSERS
Joe Mooney
Advanced Paramedic National Ambulance service
Multidisciplinary Study day Thursday 26th September 2019.
Twitter: @
josephmooney
Slide2National Ambulance Service
EMTs, Paramedics, Advanced Paramedics
Emergency ambulance, motorbikes, RRVs, ICVs,
Bumbulance, IPATS, MICAS, NNTP, supported by Irish air corps and Irish Coast Guard with helicopters, Dublin area we have 4 stations, Swords, Dublin South Central(Inchicore), Tallaght and Loughlinstown
Slide3Our roles (I believe are)
To support patients and family's at this difficult time
To diminish pain and suffering
To understand the needs of these patients To not bring patients to ED if not required To educate staff of NAS in palliative care
Slide4Challenges
Palliative care is an ever growing aspect of pre hospital work- with little or no formal training
Called to the sickest patients in the community with limited knowledge of these patients.
Family's expect us to do interventions (sometimes)DNARs not available in the community or nursing homes (sometimes) For hospice staff to understand the role and abilities of pre hospital care providers in delivering end of life care.
Accessing out of hours palliative care teams via ambulance crews.It’s a grey area in our profession CPGs not enacted but we do have medico in Cork
Slide5PHECC CPGs
Slide6Slide7Slide8What CPG should say
………………………………..…. DO AS HOME CARE PLAN SAYS
Slide9Research around the world
Slide10Slide11Unpublished** research from medico cork
Five organizing themes came up:
1. education and training; , limited training in managing end of life scenarios and inadequate staff supports
2. current clinical practice guidelines; lack of support from current clinical practice guidelines3. communication; Poor communication between those involved in patient care
4. environment The environment in which end of life patients were managed also had an effect on how challenging paramedical practitioners found the call.5. staff support, The environment in which end of life patients were managed also had an effect on how challenging paramedical practitioners found the call. Conclusions: The pathway to improving end of life care must include an emphasis on improvements in practitioner education and training, enhanced communication between all those involved in a patient’s care and offering non didactic clinical practice guidelines that are practitioner driven and patient-focused. It must also include increased psychological supports for paramedical practitioners dealing with end of life patients.
Slide12Do Things need to change ?
Pre hospital cardiac arrest ? Or peacefully died at home ?
Some level of training for paramedics as part of their training
Enacted palliative care CPGDNAR standard across all health care with agreement with what is a ‘recent’ timeframe for them to be accepted by ambulance crews
Slide13Positive steps forward
Slide14Thank you very much
Any questions