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56 Paramedics’ understanding and interpretation of advance care planning: a pilot questionnaire-based study
  1. Edward Presswood,
  2. Siwan Seaman,
  3. Ed O’Brian and
  4. Anthony Byrne
  1. Wales Deanery, Marie Curie Hospice Cardiff and Vale, Welsh Ambulance Service NHS Trust, Wales Cancer Trials Unit


Background Paramedics are often the first healthcare professionals to respond to changes in a patient’s condition. However, there has been no previous studies into paramedics’ understanding of legislation relating to advance care planning (ACP), or how they interpret ACP documents. The aim of this pilot study was to find out what knowledge paramedics had about ACP legislation, and how uniformly they interpreted ACP documents.

Methods We invited paramedics to complete a questionnaire about ACP. There were four true-or-false questions about the legal aspects of ACP. The questionnaire also included a hypothetical scenario and simulated Do Not Attempt Cardio-Pulmonary Resuscitation form related to the scenario. The paramedics were asked whether they would, or would not, start CPR in that scenario.

Results Fifteen paramedics completed the questionnaire. Five reported that they had previously been taught about legal aspects of advance care planning. The correct answers to the true false questions varied between 67% and 87%. Six paramedics completed the scenario question. Five indicated that they would not start CPR. One paramedic indicated that they would start CPR.

Conclusions This pilot study indicates that up to third of paramedics might misunderstand some of the legal aspects relating to ACP. It also indicates a lack of uniformity in how paramedics interpret ACP documents. This study should raise awareness that ACP documents might not always be interpreted as intended. We will use these finding to explore the interpretation of ACP documents in a larger cohort.

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