Down with falls! Paramedicine scope regarding falls amongst older adults in rural and remote communities: A scoping review

Abstract

AbstractIntroductionAustralian rural and remote areas are faced with the double burden of an ageing population paired with inequitable access to health resources due to the paradigm of major city centred health care. This complicates fall management within this space. Paramedics are a registered health profession, which provides mobile, equitable health care. However, this resource is not being effectively utilised in rural and remote areas where primary care access barriers may cause patient needs to go unmet.ObjectiveTo describe the existing literature and describe the international scope of current paramedicine practice in the out‐of‐hospital management of falls amongst older adults in rural and remote settings.DesignJoanna Briggs Institute scoping review methodology was employed. CINAHL (EBSCO), MEDLINE (Ovid), EMBASE (Ovid), SCOPUS (Elsevier), Google Scholar and These Global were searched and Australian, New Zealand and the UK ambulance service guidelines were sought.FindingsTwo records met inclusion criteria. Currently, rural and remote paramedic fall management involves preventative health promotion through patient education, population‐based screening and referrals.DiscussionThe use of paramedics to screen at‐risk populations and refer is vital, as many rural adults had screened positive to fall risks and other unmet needs. There is poor recollection of physically printed education material and low acceptance of further in‐home assessments following paramedic departure.ConclusionThis scoping review has highlighted a significant knowledge gap on this topic. Further research is needed to effectively utilise paramedicine within areas where access to primary care is not possible to achieve downstream, risk reducing care in the home.