SynthesisScandinavian journal of trauma, resuscitation and emergency medicine2019
Clinical reasoning in the emergency medical services: an integrative review.
Synthesis in Scandinavian journal of trauma, resuscitation and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers.
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Who cites it
42 citing papers in PubMed.
- Cognitive strategies in the Emergency Medical Services: proposal for a conceptual integrated framework to explicate clinical reasoning in EMS.International journal of emergency medicine · 2026Article
- Associations Among Emotional Intelligence, Job Stress, and Clinical Decision-Making in Prehospital Emergency Staff: A Cross-Sectional Study.Health science reports · 2026Article
- Article
- The induction process of new professionals in the Swedish ambulance service - a document analysis.BMC medical education · 2026Article
- Article
- Ethical challenges and action alternatives: Case reflections in ambulance care.Nursing ethics · 2026Article
- Risk assessment reasoning and decision-making by ambulance professionals in patients with a transient loss of consciousness: a qualitative study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Collaboration among emergency first responders at major incidents - an explorative focus group study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Cardiorespiratory and Glycaemic Changes Following Prehospital Nebulised Salbutamol in Acute Asthma: A Mixed Retrospective and Prospective Observational Study.Journal of asthma and allergy · 2026Article
- DeepSeek-R1 vs OpenAI o1 for Ophthalmic Diagnoses and Management Plans.JAMA ophthalmology · 2025Article
- Bracing for the next wave: A critical incident study of frontline decision-making, adaptation and learning in ambulance care during COVID-19.Journal of advanced nursing · 2025Article
- Characterization and Application of Statewide Emergency Medical Services Advanced Life Support Protocols.Cureus · 2025Article
- Ambulance professionals' adaptations in prehospital services: a critical incident study.BMC emergency medicine · 2025Article
- Ambulance Nurses' Experience of a Simulation Exercise Concerning Intimate Partner Violence.International nursing review · 2025Article
- Influence of risk literacy, decision-making styles and motivation on clinical reasoning in medical students: an ordinal logistic regression analysis.BMC medical education · 2025Article
- Exploring care pathways of patients conveyed by emergency medical services (EMS) through electronic health records.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Collaboration between ambulance services and primary care: a scoping review protocol.BMJ open · 2025Article
- Nurses' use of an advisory decision support system in ambulance services: A qualitative study.Journal of advanced nursing · 2025Article
- The impact of shift work on paramedics and their practice: Protocol for a simulated paramedic shift work study.PloS one · 2025Article
- Paramedic perceptions of decision-making when managing mental health-related presentations: a qualitative study.BMC medical informatics and decision making · 2024Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clinical reasoning is the process of gathering and understanding information conducted by clinicians in the emergency medical services (EMS) so as to make informed decisions. Research on clinical reasoning spans several disciplines, but a comprehensive view of the process is lacking. To our knowledge, no review of clinical reasoning in the EMS has been conducted.
aimThe aim was to investigate the nature, deployment, and factors influencing EMS clinicians' clinical reasoning by means of a review.
methodData was collected through searches in electronic databases, networking among research teams, colleagues and friends, "grey literature," and through ancestry searches. A total of 38 articles were deemed eligible for inclusion and were analyzed using descriptive thematic analysis. The analysis resulted in an overarching finding - namely, the importance for EMS clinicians to adjust for perceived control in unpredictable situations. Within this finding, 3 themes emerged in terms of EMS clinicians' clinical reasoning: (1) maintaining a holistic view of the patient; (2) keeping an open mind; and (3) improving through criticism. Seven subthemes subsequently emerged from these three themes.
resultsThis review showed that EMS clinicians' clinical reasoning begins with the information that they are given about a patient. Based on this information, clinicians calculate the best route to the patient and which equipment to use, and they also assess potential risks. They need to be constantly aware of what is happening on the scene and with the patient and strive to control the situation. This striving also enables EMS clinicians to work safely and effectively in relation to the patient, their relatives, other clinicians, associated organizations, and the wider community. A lack of contextually appropriate guidelines results in the need for creativity and forces EMS clinicians to use "workarounds" to solve issues beyond the scope of the guidelines available. In addition, they often lack organizational support and fear repercussions such as litigation, unemployment, or blame by their EMS or healthcare organization or by patients and relatives.
conclusionClinical reasoning is influenced by several factors. Further research is needed to determine which influencing factors can be addressed through interventions to minimize their impact on patient outcomes.
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