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. 2020 Sep 18;10(9):e036925.
doi: 10.1136/bmjopen-2020-036925.

Death and dying in prehospital care: what are the experiences and issues for prehospital practitioners, families and bystanders? A scoping review

Michelle Myall  1 , Alison Rowsell  2 , Susi Lund  2 , Joanne Turnbull  2 , Mick Arber  3 , Robert Crouch  2   4 , Helen Pocock  5   6 , Charles Deakin  5   7 , Alison Richardson  2   4
Affiliations

Death and dying in prehospital care: what are the experiences and issues for prehospital practitioners, families and bystanders? A scoping review

Michelle Myall et al. BMJ Open. .

Abstract

Objective: To identify the factors that shape and characterise experiences of prehospital practitioners (PHPs), families and bystanders in the context of death and dying outside of the hospital environment where PHPs respond.

Design: A scoping review using Arksey and O'Malley's five-stage framework. Papers were analysed using thematic analysis.

Data sources: MEDLINE; Embase; CINAHL; Scopus; Social Sciences Citation Index (Web of Science), ProQuest Dissertations & Theses A&I (Proquest), Health Technology Assessment database; PsycINFO; Grey Literature Report and PapersFirst were searched from January 2000 to May 2019.

Eligibility criteria for selecting studies: Qualitative and mixed methods studies reporting the experiences of PHPs, families and bystanders of death and dying in prehospital settings as a result of natural causes, trauma, suicide and homicide, >18 years of age, in Europe, USA, Canada, Australia and New Zealand.

Results: Searches identified 15 352 papers of which 51 met the inclusion criteria. The review found substantial evidence of PHP experiences, except call handlers, and papers reporting family and bystander experiences were limited. PHP work was varied and complex, while confident in clinical work, they felt less equipped to deal with the emotion work, especially with an increasing role in palliative and end-of-life care. Families and bystanders reported generally positive experiences but their support needs were rarely explored.

Conclusions: To the best of our knowledge this is the first review that explores the experiences of PHPs, families and bystanders. An important outcome is identifying current gaps in knowledge where further empirical research is needed. The paucity of evidence suggested by this review on call handlers, families and bystanders presents opportunities to investigate their experiences in greater depth. Further research to address the current knowledge gaps will be important to inform future policy and practice.

Keywords: accident & emergency medicine; palliative care; qualitative research.

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Conflict of interest statement

Competing interests: Alison Richardson is a National Institute for Health Research (NIHR) senior investigator. HP is in receipt of an NIHR Clinical Doctoral Fellowship.

Figures

Figure 1
Figure 1
Search strategy.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) flow diagram.
See this image and copyright information in PMC

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