Research Within DFCM's Paramedicine Collaborative

Prehospital medicine continues to rapidly evolve with new treatments and interventions aimed at providing a more patient-centred approach to care and improving the outcomes for patients treated by paramedics. This program of research focuses on improving clinical care and health service delivery through the implementation of clinical trials and the development of observational research studies in prehospital medicine. Some of the ongoing clinical trials include:

• Optimizing Ventilation to Improve Outcomes from Cardiac Arrest: OPTIVO Randomized Controlled Trial, which is the first trial to investigate ventilation strategies in cardiac arrest management.
• Paramedic Initiated Treatment Targeting Sepsis in Out-of-Hospital Patients: PITSTOP Randomized Controlled Trial, which aims to investigate the impact of paramedic-initiated antibiotics and aggressive blood pressure management in patients who present with sepsis.
• The Study of Whole Blood in Frontline Trauma: SWIFT, which examines the use of whole blood in prehospital hemorrhagic shock.
• Canadian Prehospital Syncope Score: CPSS – validation study, which aims to validate the CPSS clinical tool for identification of low-risk patients who present with a chief complaint of syncope.

Partners/Supporters: Sunnybrook Health Science Centre, St. Michael’s Hospital, multiple Paramedic Services from across Canada, and the Ottawa Hospital Research Institute; funded by Canadian Institutes of Health Research and ZOLL Medical.

Research Program Lead: Dr. Ian Drennan (ian.drennan@utoronto.ca) 

Website: FIRST 60: Prehospital, Trauma and Resuscitation Sciences website.

The Canadian health care system is facing significant challenges that require innovative solutions. As the demand for health care services increases and service delivery models change and evolve, paramedicine systems must adapt to become more effective in being part of health care solutions. Improving Patient Access to Care in the Community (IMPACC) is a large collaborative multi-study program of research that aims to contribute to the redesign of paramedicine systems. While maintaining the critical role in emergency care, the goal is to also rethink and ultimately redesign paramedicine systems to broaden health and social services and to support the integration of paramedicine into broader interprofessional primary care teams and services. 

Partners/Supporters: Department of Health and Society, Department of Family and Community Medicine, York Region Paramedic Services, Team Primary Care, Foundation for Advancing Family Medicine, Paramedic Association of Canada, and Paramedic Chiefs of Canada.  

Learners: Lindsay Henderson

Research Program Lead: Dr. Walter Tavares (walter.tavares@utoronto.ca)

Many people experiencing a mental health crisis rely on 911 dispatchers, paramedics, police, and hospital emergency department services, however, many of these first responders lack sufficient mental health resources, training, and have minimal options to offer when providing this type of care. This project brings together the perspectives of community-based service organizations, emergency care providers, and individuals with lived experience to address responses to mental health emergencies in Ontario and aims to co-develop workshops and training, as well as reports and policy recommendations so the results can be implemented in mental health emergency care. The goal is to highlight and develop collaborative practices that appropriately support all members of the community requiring emergency mental health support, particularly those of lower socioeconomic status, Black and Indigenous communities, People of Colour, 2SLGBTQ+ communities, and immigrants.  

Partners/Supporters: Humber Institute of Technology & Advanced Learning, Middlesex-London Paramedic Service, TAIBU Community Health Centre, York University (Collaborator), University of Calgary (Collaborator); funded by the Natural Science and Engineering Research Council of Canada and the College & Community Social Innovation Fund.

Learners: Chiemela Iheanacho, Petra Meijer 

Research Program Lead: Dr. Polly Ford-jones (polly.ford-jones@humber.ca)

Website: Mental Health Crisis Care

Paramedics are an important part of Canada’s public safety infrastructure, but the nature of their work exposes them to a multitude of dangers, including workplace violence. A majority of surveyed paramedics have experienced verbal abuse, threats, and physical or sexual assault. Despite the potential for significant physical and psychological harm, incidents are rarely reported, due in part to a professional culture that encourages paramedics to accept them as "part of the job." This makes finding solutions to the problem very difficult. Our team has been working with paramedics in Ontario's Peel Region since 2019 to develop a first-of-its-kind process to track exposure to violence, support paramedics who have been victimized, and use the information to mitigate the risk of harm in the future. Leveraging this new reporting process, we are working with paramedic services from across Canada to better understand:

• how commonly paramedics are subjected to violence;
• what types of emergency calls have an increased risk of violent encounters; and
• how being exposed to violence may impact paramedics’ health, well-being, job satisfaction, and intention to leave the profession.

Research Program Lead: Dr. Justin Mausz (justin.mausz@peelregion.ca)

Partners/Supporters: Peel Regional Paramedic Services, Department of Family and Community Medicine, University of Windsor, and Queen's University.

Learners: Undergraduate students

Website: Protect Paramedics