Introduction: Since the late 1960s, paramedics have been tasked at providing care to unstable pre-hospital patients. With the advent of advanced flight and critical care paramedic training, transport paramedics are increasingly called upon to provide scene and interfacility care to the sickest cohorts of patients. Pre-hospital critical care has been associated with lower rates of mortality in some populations. The Fundamental Critical Care Support course (FCCS) has been used to provide standardized critical care education to an interprofessional audience. Our goal was the evaluation of the effect of FCCS participation on paramedic confidence with management of critically ill patients. Methods: Between May 2018 and November 2019, paramedics taking part in our institutions multidisciplinary FCCS course were invited to participate in a study assessing the impact of FCCS participation. Across 11 critical care domains, 5-point Likert scales were used to assess critical care confidence along with a summed total. Students were surveyed in the pre-course, post-course, and 3-months follow-up periods. A combination of parametric and non-parametric methods were used for statistical analysis. Results: A total of 28 paramedics enrolled in the study and completed the pre-course survey. Three participants (10.7%) dropped out after initial enrollment and 25 (89.3%) completed the post-course survey (which included demographic information). An additional 3 participants dropped out in the follow-up period for total 3-month follow-up participation of 22 (78.6% of initial enrollment). The majority of participants were male (17/25, 68%) and the mean age was 37.7. Average time in practice was 11.8 years. Total confidence in critical care assessment and management improved after course participation (p< 0.0001) and was significant in 7 of the 11 domains. In the 3-month follow-up period, confidence levels were maintained in all domains, but continued to improve for respiratory failure (p=0.0156). Conclusions: Paramedics’ overall confidence with critically ill patient management significantly increased after FCCS participation. FCCS is now an institutional requirement for our critical care paramedics. However, further study is needed to evaluate if paramedic FCCS involvement results in direct improvements in patient care.
Bath et al. (Sun,) studied this question.