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Emergency medicine
Original research
Death and dying in prehospital care: what are the experiences and issues for prehospital practitioners, families and bystanders? A scoping review
  1. Michelle Myall1,
  2. Alison Rowsell1,
  3. Susi Lund1,
  4. Joanne Turnbull1,
  5. Mick Arber2,
  6. Robert Crouch1,3,
  7. Helen Pocock4,5,
  8. Charles Deakin4,6,
  9. Alison Richardson1,3
  1. 1School of Health Sciences, University of Southampton, Southampton, Hampshire, UK
  2. 2York Health Economics Consortium, University of York, York, North Yorkshire, UK
  3. 3University Hospital Southampton NHS Foundation Trust, Southampton, UK
  4. 4South Central Ambulance Service NHS Foundation Trust Southern Headquarters, Otterbourne, Hampshire, UK
  5. 5Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, West Midlands, UK
  6. 6NIHR Southampton Respiratory Biomedical Research Unit, University of Southampton, Southampton, Hampshire, UK
  1. Correspondence to Dr Michelle Myall; M.Myall{at}soton.ac.uk

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.

  • qualitative research
  • accident & emergency medicine
  • palliative care
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2020-036925

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    Footnotes

    • Contributors MM, SL and ARi designed the review. MA developed the search strategy and performed the searches. SL, ARo, MM and JT screened the titles, abstracts and full papers. SL and ARo performed data extraction. MM, SL, ARo carried out data analysis. MM, SL and ARo drafted the manuscript. MM, SL, ARi, JT, ARo, MA, RC, HP and CD reviewed the paper for important intellectual content. MM, SL, ARi, JT, ARo, MA, RC, HP and CD approved the final version of the paper.

    • Funding This work was supported by the National Institute for Health Research (NIHR) through the Collaboration for Leadership in Applied Health Research and Care Wessex (NIHR CLAHRC Wessex) programme.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data sharing not applicable as no data sets generated and/or analysed for this study. No additional data are available.