How Lab Results Guide Paramedic Decision-Making in Acute Situations

Abstract

In emergency medicine, paramedics must quickly and accurately make therapeutic and transport decisions. Laboratory and test findings are critical for guiding paramedic decision-making in acute situations before hospital arrival. Among many interrogated tests, serial blood glucose tests effectively ruled out hyperglycemic and hypoglycemic events, which required fast transport. Interrogated lab results provided valuable additional info such as potential prevalence of cardiac disease and renal failure, along with pre-existing laboratory findings. This study uniquely investigates how specific lab results impact paramedic decision-making. Prior studies identified lab results that could be interrogated and correlated the detection of abnormal lab results with therapeutic and transport decisions. However, the agent and informants in these investigations were either the healthcare provider or the hospital. Thus, while lab results that could be interrogated were identified, the subsequent decision-making utilized lab results interrogated by the paramedics were under-explored. This limitation can be partially ascribed to the inherent difficulty in accessing paramedic data in the emergency medical service sector and confidentiality concerns regarding patient safety and privacy. However, it also remains to be understood how this knowledge affects paramedic treatment and decision-making.

Neuroscience and cognition perspectives of framing and embodiment remain under-explored in emergency medical services. This study uncovered how lab results outcome, type of interrogated lab results, and biomedical portrayals of interrogated lab results affect paramedic decisions on patient management and transport. The research goal extends beyond examining how lab results affected paramedic communication and consultation with off-site medical personnel. It is also concerned with how this affected paramedic patient management, including further treatment and diagnostic testing, and transport decision-making. Prior studies in emergency medicine mainly focus on knowledge which assists decision-making, under-explored in general. Prior studies in emergency medicine similarly mostly investigated the role of knowledge in decision-making. For example, one study examined how communicative foresight affects emergency department resource allocation decision-making, while another study investigated how the temporal foresight of staff constraints in an emergency department affects decision-making. Prior studies in emergency medicine have also investigated how decision-making is affected by emotions.