Abstract
Introduction: Japan has had a paramedic service since 1991. These paramedics have since been permitted to administer medical treatments including infusion, tracheal intubation, and epinephrine injection for cardiopulmonary arrest patients. Further medical treatments are now being designed for blood sugar measurement and glucose injection for suspected hypoglycemia, β2 stimulant inhalation for severe asthma, and infusion for patients in shock. We surveyed technical, diagnostic and psychological levels of confidence in relation to these new treatments among Japan’s paramedics.
Methods: We conducted a survey of attitudes of active paramedics in Yamagata prefecture and sent a questionnaire to fire departments in September 2012. This questionnaire comprised questions on the 4 new medical treatments, and asked paramedics to self-evaluate their level of technical confidence on a scale of 1 to 10. Furthermore, we also asked whether fire stations and individual paramedics had medical liability insurance.
Results: A total of 233 paramedics were enrolled in this study. The average technical confidence scores for blood sugar measurement, glucose injection, β2 stimulant inhalation, and infusion for shock were 7.9, 6.6, 4.1, and 6.4, respectively. The scores for blood sugar measurement and glucose injection among paramedics authorized to perform adrenaline administration were significantly higher than for paramedics unauthorized to carry out that procedure. All fire departments had medical liability insurance; however, only 21 paramedics (9%) had individual liability insurance. With the updated service comprising the administration of new treatments, 63 paramedics (27%) thought that they would take out individual liability insurance.
Conclusions: We demonstrated that the surveyed paramedics have poor levels of self-evaluated technical confidence for β2 stimulant inhalation. It is assumed that a workshop on adrenaline administration for paramedics will help improve knowledge and skills for blood sugar measurement and glucose injection. Therefore, a workshop on β2 stimulant inhalation is now also needed so that paramedics can learn more about this procedure in addition to conventional adrenaline administration. The number of lawsuits is expected to increase since paramedics will now treat more serious cases as compared to the cases prior to the introduction of the updated service. Paramedics should take account of the medical liability insurance.
