Non-transport of patients following assessment and care by paramedics: a scoping review protocol

Objective: – The objective of this scoping review will be to map the evidence on the non-transport of patients following paramedic assessment and care, focusing on patient characteristics, decision-making processes, and associated patient outcomes. Introduction: – Patients with low-acuity or non-urgent concerns are frequently encountered by paramedics and ambulance service clinicians. Traditionally, paramedics provide assessment and care to out-of-hospital patients, followed by transport to the emergency department (ED). However, many of these non-urgent or low-acuity presentations may be more appropriate for referral to non-ED health care services. There is currently little research on the safety of non-urgent patients and their clinical outcomes when these patients are not transported to hospital. Eligibility criteria: – This review will consider studies of any methodology relating to patients who have been assessed by and received care from paramedics working within an ambulance service context and who are not subsequently transported to ED. Due to inconsistency in terminology between jurisdictions, the term paramedic will be used throughout the review, but evidence that uses other terms such as emergency medical technician or advanced care paramedic will also be eligible. Methods: – This review will follow the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The following databases will be searched: MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (EBSCOhost), JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, and Scopus. Gray literature will also be searched for. Two reviewers will conduct the searches, title and abstract screening, full-text screening, and data extraction. The results will be presented in tabular format, accompanied by a narrative description.