Research Information for Paramedics
Welcome to the homepage of current and upcoming studies occurring at emergency departments for clinicians, along with resources available for clinicians interested in research.
This initiative aims to collaborate with all health care providers and make research opportunities accessible to everyone.
We can help you develop a research question, apply for grants, assist with Research Ethics Approval, and support you in the research process. Please get in touch with the Research Manager.
Megi Nallbani
megi.nallbani@nshealth.ca
902-476-1471
This site will be regularly updated.
Current Studies in the Emergency Department:
The Use of Tracheal Clicks During Direct Laryngoscopy: A Cadaveric Simulated Study Using Lightly Embalmed Cadavers. The study is seeking 50 paramedics that perform intubations. This study aims to look at the effectiveness of the use of tracheal clicks during direct Laryngoscopy under normal and stressful conditions. Participants will be requested to watch a training video detailing the tracheal clicks techniques on a cadaver. During the 4-hour session, the tube placement (trachea or esophagus) will be assessed using only tracheal clicks. One group in the study will be asked to achieve a heart rate of 150 BPM on a stationary bike before their attempts.
Eligibility: A paramedic who performs intubations as part of their normal scope of practice but has less than five intubations per year.
Goals: We hope to enroll 50 in this study.
Contact: Sebastien.Herbert@dal.ca
RAFF4 Trial: Vernakalant vs. Procainamide for Acute Atrial Fibrillation in the Emergency Department: The study takes place at 12 Emergency Departments across Canada. This study aims to determine whether IV vernakalant is a more effective, faster, and safer drug than IV procainamide in treating patients with acute atrial fibrillation in the emergency department (ED).
The study asks whether it is better to give intravenous (IV) procainamide or IV vernakalant. While both medications are approved for use by Health Canada, vernakalant is a newer drug that emergency departments across Canada have not widely adopted. This study will compare these two treatment options to see if one is better than the other.
Participants will be assigned to 1 of 2 treatment groups. Depending on which treatment group the participant is assigned to, the participant will receive either an approved dose of IV procainamide or an approved dose of IV vernakalant. After their visit, they will be contacted in 30 days by telephone.
Eligibility: A conscious adult over the age of 18 who is currently experiencing atrial fibrillation for over 3 hours and under seven days. The research assistant will be notified and continue to investigate for further inclusion/exclusion criteria for the study
Clinician Involvement: Anyone can notify the research assistants of potential patients eligible for the study.
The attending physician will consult with the RA and review the inclusion/exclusion criteria for the participants and order the medications
The attending nurse will retrieve and infuse the medications as per study protocol.
Other opportunities for ECG and cardioversion if medication administration is unsuccessful.
Goals: We hope to enroll 340 in this study.
Canadian COVID-19 Emergency Department (ED) Rapid Response Network (CCEDRRN): Since 2020, the registry has looked at multiple factors for patients presenting to the emergency department with symptoms of COVID-19, tested positive or negative for COVID-19, and collecting data on medications, vitals, bloodwork. This registry also includes a telephone follow-up with patients screened at 30 days, 3 and 6 months, and a year since their initial ED visit on post-COVID symptoms, experiences, and vaccination statuses.
Clinician involvement: none; there is no direct patient contact for this study
Goals: We would like to publish a few publications on the data analysis of the multiple factors collected.
Understanding cannabis-related physical and mental health presentations to the Emergency Department following the legalization of non-medical cannabis use. The study aims to investigate in-depth patients with adverse events about cannabis use requiring ED presentations, including the important determination of associated risk factors and healthcare demands. This unique collaborative Emergency Medicine and Psychiatry study will be completed in Nova Scotia at the four adult EDs (Halifax, Dartmouth, Sackville and Sydney) and the IWK Children’s Hospital ED. For the individuals who consent, in addition to the chart review data, we will collect healthcare and interview/rating scale data at the study entry and three months later. We will also retrospectively collect data on healthcare contacts 24 months before the emergency department visit for those enrolled in this part of the study. Participants will also be involved in a phone interview about cannabis use (including strain, method of use, and frequency).
Eligibility: Individuals presenting to the ED with a cannabis-related complaint from age 10+ will be offered enrollment in the study.
Clinician involvement: referral to the study
Goal: 1500 participants
Upcoming studies in the Emergency Department:
REmote cardiac MOnitoring of at-risk SYNCope patients after Emergency Department discharge – A Multicenter Randomized Controlled Trial: (REMOSYNCED – RCT). Participants in the study will be approached if they are in the ED after having a fainting episode. This study aims to see if 15-day outpatient cardiac monitoring detects more patients with heart rhythm problems requiring treatment than usual care. We also will compare if such monitoring can: (1) Rule out heart rhythm problems among patients if they suffer fainting or near-fainting during the monitoring; (2)Identify other conditions that are not heart rhythm related; (3) Assess if we can achieve the same effect (detecting heart rhythm problems with shorter duration of monitoring).
An observational study within this study will use already collected information to understand the syncope risk score better.
Clinician involvement: fill out the form; ED RA will collect the forms. If the participant’s score is under 3, the participant will receive a telephone follow-up; if it is above 3, the participant will be contacted by Cardiology RA to arrange cardiac monitoring.
Goal: Enroll 74 participants between Halifax Infirmary and Dartmouth General Hospital.
Proposed Start: September 2022
Atlantic Canadian Emergency Medicine Airway Interventions Registry and Observational (AIRO) Database: This study’s primary objective is to examine the epidemiology of ED airway management in multiple Atlantic Canadian EDs. There currently is none- this study will likely be the first. The study will collect retrospective, observed and self-reported data on ED airway interventions and associated outcomes. The data form already exists in circulation – the study will input this data into a database and assess the factors found.
Clinician involvement: To complete and ensure the Airway Assessment and Management form is filled out and submitted to the Pod 1 Intubation box for data entry.
Goals: We are approved for Nova Scotia – we hope to share data with New Brunswick, then develop a registry where clinicians can contribute to research.
Proposed Start: TBD
Resources for Paramedics:
Grants and Bursaries offered by Dalhousie University:
Research Performance Grant – supporting pre-hospital research
Two of these bursaries will be awarded annually to offset the direct costs of performing pre-hospital research. A performance bursary can be up to $5,000 and can be renewed once after the submission of a progress report to the Division of EMS.
Application deadlines: February 1 and September 1.
https://medicine.dal.ca/departments/department-sites/emergency/divisions/ems/education/bursaries/research-performance.html
Research Knowledge Translation Grant – supporting the sharing of knowledge
The Knowledge Translation Bursary is awarded to help with costs associated with presenting original research at research sessions and conferences. The applicant must be either the primary investigator or co-investigator and the presentation may be oral or via poster.
The bursary is worth up to $3,000. A maximum of $6,000 can be awarded annually (two bursaries of $3,000 each or three bursaries of $2,000 each).
Application deadline: There are two application deadlines per year (March 31 & September 30)
https://medicine.dal.ca/departments/department-sites/emergency/divisions/ems/education/bursaries/knowledge-translation.html
Research Postgraduate Bursary – supporting paramedic training
This bursary is awarded annually to a paramedic wishing to enroll in a master’s or PhD program at a recognized institution. An amount of up to $3,000 per year, for a maximum of two years, is available to help cover tuition costs
Clinical Cadaver Research Program Grant
This grant is available for projects that use clinical cadavers as a source of research with the ultimate goal of improving patient outcomes. This includes research projects in undergraduate, postgraduate and continuing medical education in which clinical cadavers are used. In addition, projects that impact a broad group of learners and contribute to our understanding of how cadavers are best used as a simulation resource will be given preference.
In addition, there are bursaries and grants through other funding agencies; please contact the Research Manager.
Research Courses and Opportunities
Paramedic-Evidence Based Practice Couse (P-EBP)
Offered in-person and online, this course was developed to give paramedics the tools to search for answers to their clinical questions. The P-EBP focuses on developing a concise PICO question, creating a search strategy in PubMed, and critically appraising the literature they uncover. In addition, the course introduces concepts of research study design, ethics, validity, and level of evidence and briefly touches on bio-stats.
Cost: $40-60
https://emspep.cdha.nshealth.ca/Default.aspx
Prehospital Evidence-Based Practice Program
The PEP program primarily aims to share information with the EMS community. Appraisers volunteer their time and efforts to contribute to the Program. Appraisers will read one article each month and rank the evidence and intervention
The purposes of the Prehospital Evidence-Based Practice Program are.
- to catalogue EMS studies
- to stimulate debate and growth towards evidence-based clinical presentations
- to be a resource for developing local EMS clinical presentations, perhaps with a movement towards “best practice” paramedic clinical presentations.
- to be a guide to help recognize opportunities for pre-hospital research.
- to develop a process of using evidence to evaluate practice change suggestions made by paramedics.
https://emspep.cdha.nshealth.ca/Default.aspx
Publications:
Jensen J, Travers A, Carter A. Care begins when 9-1-1 is called: the evolving role of paramedic specialists in EMS Medical Communications Centres. CJEM 2022; 24(2):115=6
Carrigan S, Goldstein J, Carter A, Asada Y, Travers A. The prevalence and characteristics of non-transports in a provincial emergency medical services program: A population-based study. J Emer Med 2022; 1-11
Hurtubise M, Stirling J, Greene J, Carter A, Swain J, Brown R, Fidgen D, Goldstein J. Dextrose 50% versus Dextrose 10% or Dextrose Titration for the Treatment of Out-of-Hospital Hypoglycemia: A Systematic Review. Prehosp Dis Med 2021; 36(6):730-8