Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis

Abstract Introduction Over the past three decades, more advanced pre-hospital systems have increasingly integrated physicians into targeted roles, forming interprofessional teams. These teams focus on providing early senior decision-making and advanced interventions while also ensuring rapid transpo...

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Main Authors: Matthew D. Lavery, Arshbir Aulakh, Michael D. Christian
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s13049-024-01298-8
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author Matthew D. Lavery
Arshbir Aulakh
Michael D. Christian
author_facet Matthew D. Lavery
Arshbir Aulakh
Michael D. Christian
author_sort Matthew D. Lavery
collection DOAJ
description Abstract Introduction Over the past three decades, more advanced pre-hospital systems have increasingly integrated physicians into targeted roles, forming interprofessional teams. These teams focus on providing early senior decision-making and advanced interventions while also ensuring rapid transport to hospitals based on individual patient needs. This paper aims to evaluate the benefits of an inter-professional care model compared to a model where care is delivered solely by paramedics. Methodology A meta-analysis and systematic review were conducted using the guidelines of PRISMA 2020. Articles were identified through a systematic search of three databases and snowballing references. A systematic review was conducted of articles that met the inclusion criteria, and a suitable subset was included in a meta-analysis. The survival and mortality outcomes from the studies were then pooled using the statistical software Review Manager (RevMan) Version 8.2.0. Results Two thousand two hundred ninety-six articles were found from the online databases and 86 from other sources. However, only 23 articles met the inclusion criteria of our study. A pooled analysis of the outcomes reported in these studies indicated that the mortality risk was significantly reduced in patients who received pre-hospital care from interprofessional teams led by physicians compared with those who received care from paramedics alone (AOR 0.80; 95% CI [0.68, 0.91] p = 0.001). The survival rate of critically ill or injured patients who received pre-hospital care from interprofessional teams led by physicians was increased compared to those who received care from paramedics alone (AOR 1.49; 95% CI [1.31, 1.69] P < 0.00001). Conclusions The results of our analysis indicate that the targeted deployment of interprofessional teams led by physicians in the pre-hospital care of critically ill or injured patients improves patient outcomes.
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spelling doaj-art-4ea6a0f74eeb4c378fae2b4eba0efcd32025-08-20T03:40:50ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-01-0133111310.1186/s13049-024-01298-8Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysisMatthew D. Lavery0Arshbir Aulakh1Michael D. Christian2Southern Medical Program, Faculty of Medicine, University of British ColumbiaSouthern Medical Program, Faculty of Medicine, University of British ColumbiaRural Coordination Centre of BC (RCCbc)Abstract Introduction Over the past three decades, more advanced pre-hospital systems have increasingly integrated physicians into targeted roles, forming interprofessional teams. These teams focus on providing early senior decision-making and advanced interventions while also ensuring rapid transport to hospitals based on individual patient needs. This paper aims to evaluate the benefits of an inter-professional care model compared to a model where care is delivered solely by paramedics. Methodology A meta-analysis and systematic review were conducted using the guidelines of PRISMA 2020. Articles were identified through a systematic search of three databases and snowballing references. A systematic review was conducted of articles that met the inclusion criteria, and a suitable subset was included in a meta-analysis. The survival and mortality outcomes from the studies were then pooled using the statistical software Review Manager (RevMan) Version 8.2.0. Results Two thousand two hundred ninety-six articles were found from the online databases and 86 from other sources. However, only 23 articles met the inclusion criteria of our study. A pooled analysis of the outcomes reported in these studies indicated that the mortality risk was significantly reduced in patients who received pre-hospital care from interprofessional teams led by physicians compared with those who received care from paramedics alone (AOR 0.80; 95% CI [0.68, 0.91] p = 0.001). The survival rate of critically ill or injured patients who received pre-hospital care from interprofessional teams led by physicians was increased compared to those who received care from paramedics alone (AOR 1.49; 95% CI [1.31, 1.69] P < 0.00001). Conclusions The results of our analysis indicate that the targeted deployment of interprofessional teams led by physicians in the pre-hospital care of critically ill or injured patients improves patient outcomes.https://doi.org/10.1186/s13049-024-01298-8Pre-hospital careOut-of-hospital cardiac arrestTraumaResuscitationPre-hospital emergency medicinePre-hospital physicians
spellingShingle Matthew D. Lavery
Arshbir Aulakh
Michael D. Christian
Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Pre-hospital care
Out-of-hospital cardiac arrest
Trauma
Resuscitation
Pre-hospital emergency medicine
Pre-hospital physicians
title Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
title_full Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
title_fullStr Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
title_full_unstemmed Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
title_short Benefits of targeted deployment of physician-led interprofessional pre-hospital teams on the care of critically Ill and injured patients: a systematic review and meta-analysis
title_sort benefits of targeted deployment of physician led interprofessional pre hospital teams on the care of critically ill and injured patients a systematic review and meta analysis
topic Pre-hospital care
Out-of-hospital cardiac arrest
Trauma
Resuscitation
Pre-hospital emergency medicine
Pre-hospital physicians
url https://doi.org/10.1186/s13049-024-01298-8
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