Abstract
Background and aimsPrehospital critical care for out‐of‐hospital cardiac arrest (OHCA) is a complex and largely unproven intervention. During research to examine this intervention, we noted significant differences in stakeholders' views about research, randomisation, and the funding of prehospital critical care for OHCA. We aimed to answer the following questions: What are stakeholders' priorities for prehospital research? What are stakeholders' views on randomisation of prehospital critical care? How do stakeholders consider allocation of resources in prehospital care?MethodsWe undertook an explanatory qualitative framework analysis of interviews and focus group with 5 key stakeholder groups: patients and public, air ambulance charities, ambulance service commissioners, prehospital researchers, and prehospital critical care providers.ResultsWe undertook 3 focus group discussions with a total of 23 participants and 8 interviews with a total of 9 participants. Despite sharing a common appreciation of the concepts of scientific enquiry, fairness, and beneficence, the 5 relevant stakeholder groups displayed divergent views of research and funding strategies regarding the intervention of prehospital critical care for the condition of OHCA. The reasons for this divergence could largely be explained through the different personal experiences and situational contexts of each stakeholder group. Many aspects of the strategies suggested by the stakeholder groups only partially aligned with principles of traditional evidence‐based medicine, but were held with strong conviction.DiscussionAnalysis of the views of 5 stakeholder groups regarding research and the funding of prehospital critical care for OHCA revealed shared values but a variety of different strategies to achieve these. This knowledge can help researchers in similar fields in the planning and presentation of their research, to maximise impact on decision making.
Highlights
Out‐of‐hospital cardiac arrest (OHCA) is defined as the sudden cessation of cardiac activity, leading to collapse and absence of signs of life, outside of the hospital setting.[1]
Prehospital critical care can be described as a bundle of interventions beyond the remit of standard emergency medical service (EMS) treatment, delivered by a group of specialist prehospital health care providers.[6]
The mechanisms by which prehospital critical care might improve outcomes in OHCA are the experience of the providers, advanced interventions, or the ability to transfer patients over greater distances to cardiac arrest centres, using equipment and interventions not available to advanced life support (ALS) paramedics.[6]
Summary
Out‐of‐hospital cardiac arrest (OHCA) is defined as the sudden cessation of cardiac activity, leading to collapse and absence of signs of life, outside of the hospital setting.[1]. Despite sharing a common appreciation of the concepts of scientific enquiry, fairness, and beneficence, the 5 relevant stakeholder groups displayed divergent views of research and funding strategies regarding the intervention of prehospital critical care for the condition of OHCA. The reasons for this divergence could largely be explained through the different personal experiences and situational contexts of each stakeholder group. Discussion: Analysis of the views of 5 stakeholder groups regarding research and the funding of prehospital critical care for OHCA revealed shared values but a variety of different strategies to achieve these This knowledge can help researchers in similar fields in the planning and presentation of their research, to maximise impact on decision making
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