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Supporting Community-Based Care Using Paediatric Palliative Care Ambulance Plans: a Retrospective Study

Oral Presentation

October 14th 2022 at 3:00pm

Institution: Sydney Children's Hospital and University of New South Wales - New South Wales, Australia


Families caring for a child with a life-limiting condition value community-based care. However, acute crises may occur at times when the patient’s palliative care team and general practitioner are unavailable. Hence, ambulance paramedics may be called to assist. The NSW Ambulance Paediatric Palliative Care Plans (‘Plans’) were implemented in 2011 to provide attending paramedics with key information regarding a child’s medical history and goals of care. To date, the utilisation of these Plans has not been evaluated.


This study aimed to describe the patient population with Plans and provide details regarding Plan completion, paramedic responses at ambulance callouts, and the correspondence between Plan recommendations and paramedic responses.


A retrospective data review was conducted for children (≤18 years) with a Plan lodged 2017-2019. Information regarding associated ambulance callouts (2018-2019) was retrieved. Plan data was coded for patient details, completeness, and care preferences. Paramedic callout notes were coded for paramedic responses.


Data for 141 Plans and 199 associated ambulance callouts were retrieved. Neurological conditions and cancers were the most common diagnoses of patients with Plans. Almost half the Plans suggested use of medications outside general paramedic scope of practice. Callout reasons included symptom management, planned transfer, patient death, and end-of-life care. Over two-thirds of callouts occurred after-hours (when other services may be less available). Following paramedic arrival, 83.4% of patients were transported to another location. There was high correspondence between interventions suggested in Plans and interventions performed by paramedics. Only 25.3% of paramedic callout notes included reference to Plans being sighted.


This study provided detailed information about the population for whom Plans are being used and nature of associated callouts. However, it is not known how often paramedics were influenced by Plans. Educational, administrative, and organisational recommendations are offered, particularly regarding inter-organisational communication in this field.


  • Dr Tiina Jaaniste

    Head of the Pain and Palliative Care Research Team - Sydney Children's Hospital & University of New South Wales

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