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Patel, G., Phung, V.-H., Trueman, I., Pattinson, J., Botan, V. 
ORCID: 0000-0003-1583-3913, Parvin Hosseini, S.M., Ørner, R., Asghar, Z., Smith, M.D., Rowan, E., Spaight, R., Evans, J., Brewster, A., Mountain, P. and Siriwardena, A.N.,
2023.
“It's like a swan, all nice and serene on top, and paddling like hell underneath”: community first responders’ practices in attending patients and contributions to rapid emergency response in rural England, United Kingdom—a qualitative interview study.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31: 7.
ISSN 1757-7241
Abstract
Background: Community First Responder (CFR) schemes are a long-established service supplementing ambulance trusts in their local community in the United Kingdom. CFRs are community members who volunteer to respond to people with life-threatening conditions. Previous studies highlighted the motivations for becoming CFRs, their training, community (un)awareness and implications of their work on themselves and others. The practices of CFRs in prehospital care remain underexplored. Therefore, we aimed to explore real-world practice of Community First Responders and their contribution to prehospital emergency care.
Methods: We conducted 47 interviews with CFRs (21), CFR leads (15), ambulance clinicians (4), commissioners (2) and patients and relatives (5) from six ambulance services and regions of England, United Kingdom. Thematic analysis enabled identification of themes and subthemes, with subsequent interpretation built on the theory of practice wisdom.
Results: Our analysis revealed the embeddedness of the concept of doing the right thing at the right time in CFR practice. CFRs’ work consisted of a series of sequential and interconnected activities which included: identifying patients’ signs, symptoms and problems; information sharing with the ambulance control room on the patient’s condition; providing a rapid emergency response including assessment and care; and engaging with ambulance clinicians for patient transfer. The patient care sequence began with recognising patients’ signs and symptoms, and validation of patient information provided by the ambulance control room. The CFRs shared patient information with ambulance control who in turn notified the ambulance crew en-route. The practices of CFRs also included delivery of emergency care before ambulance clinicians arrived. Following the delivery of a rapid emergency response, CFRs engaged with the ambulance crew to facilitate patient transfer to the nearest medical facility.
Conclusion: The sequential CFR practices supported ambulance services in delivering prehospital and emergency care in rural areas. CFR practices were founded on the principle of practice wisdom where CFRs constructed their practice decisions based on the patient’s condition, their training, availability of equipment and medications and their scope of practice.
| Item Type: | Journal article | ||||||
|---|---|---|---|---|---|---|---|
| Publication Title: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | ||||||
| Creators: | Patel, G., Phung, V.-H., Trueman, I., Pattinson, J., Botan, V., Parvin Hosseini, S.M., Ørner, R., Asghar, Z., Smith, M.D., Rowan, E., Spaight, R., Evans, J., Brewster, A., Mountain, P. and Siriwardena, A.N. | ||||||
| Publisher: | Springer | ||||||
| Date: | 2023 | ||||||
| Volume: | 31 | ||||||
| ISSN: | 1757-7241 | ||||||
| Identifiers: |
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| Rights: | This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | ||||||
| Divisions: | Schools > School of Social Sciences | ||||||
| Record created by: | Jonathan Gallacher | ||||||
| Date Added: | 13 Jun 2023 13:04 | ||||||
| Last Modified: | 13 Jun 2023 13:04 | ||||||
| URI: | https://irep.ntu.ac.uk/id/eprint/49195 |
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