Dealing With The Unexpected in Prehospital Patientcare: The Lived Experience Of EMS Clinicians

Abstract: Background In prehospital patient care, numerous patients are examined, treated, and transported. Some are acutely seriously ill, while others, though not acutely ill, necessitate ambulance transport due to their inability to do so independently. Among the latter group, patients may be sicker than initially estimated. Objective This study aims to delineate the course of action for EMS clinicians during ordered transport, particularly in recognizing acutely ill patients within this context. It investigates the clinician's response to unexpected situations and the associated learning process, encompassing both formal and informal aspects. Method Employing a phenomenology-based approach, a detailed description of the lived experiences of EMS clinicians was constructed. Conclusion The lived experiences of EMS clinicians reveal a dynamic and resilient process when confronted with patients appearing sicker than initially reported. They employ strategic preparations and tools like the Patient Assessment Triangle to identify discrepancies. Coping involves continuous adaptation, relying on critical thinking amidst various influencing factors. Assessment of critically ill patients emphasizes flexibility and constant treatment plan adjustments. Acknowledging the complexity of pre-hospital care, adaptive decision-making and intuition play a crucial role in uncertain scenarios. EMS clinicians prioritize patient safety, integrating it into their daily practice. Despite limited explicit references to "patient safety," it's a fundamental aspect. Their resilience in navigating unforeseen challenges underscores their dedication to providing optimal care. This resilience, often overlooked amidst a focus on errors, is a significant attribute worth learning from. Through daily practice, EMS clinicians consistently strive to deliver the best and safest care to their patients, exemplifying commitment and adaptability in the face of complexity.