Abstract
Introduction
There is a broad evidence base supporting advanced life support (ALS) education to health care professionals to be structured, realistic and inclusive of a range of human factors. However, published literature largely focusses on ALS education within institutional settings such as hospitals and associated health care facilities, with typically predictable human and material resources. The aim of this paper is to explore the literature on ALS education and report the results of an international survey undertaken to identify those educational elements which differ in the pre-hospital setting compared to the institutional setting. High quality education in pre-hospital resuscitation is important because it is critical that pre-hospital professionals provide high quality ALS to maximise the likelihood of patient survival.
Methods
MEDLINE was searched using MESH terms ‘resuscitation’, ‘advanced life support’ and ‘prehospital’ as core terms. Fifteen articles relating specifically to pre-hospital resuscitation and a further 91 articles on resuscitation education were reviewed. Articles ranged in publication year from 1987 to 2016.
An online survey on ALS education was developed and administered and attracted 177 responses from a range of health care professionals nationally and internationally. A total of 83 respondents completed the full survey.
Results
The literature identifies that best practice ALS education should (a) be taught in the environment in which ALS will be performed, (b) involve team members who are similar to those they will encounter while providing ALS, and (c) use equipment the provider uses in their workplace. Human factors, in particular leadership and communication, are important components of ALS education. However, results of the survey demonstrate that best practice is not well incorporated into pre-hospital ALS education.
Conclusion
To improve pre-hospital patient outcomes and maximise the chances of patient survival, ALS education to pre-hospital providers should incorporate the context of their workplace (that is, the environment in which they function), the team members they regularly work with and the equipment they use in the pre-hospital setting. Human factors, in particular leadership, should be considered as part of pre-hospital resuscitation education.