Volume : 13, Issue : 09, September – 2026
Title:
CLINICAL DECISION-MAKING AMONG EMERGENCY MEDICAL TECHNICIANS AND PARAMEDICS IN PREHOSPITAL CARE: A SYSTEMATIC REVIEW OF INFLUENCING FACTORS, DECISION STRATEGIES, AND PATIENT-SAFETY OUTCOMES
Authors :
Saleh Baraik S Al Awadh, Ali Abdulhadi S Al Kbabah, Ali Muidh Ali Almansour, Marji Hassan Mohammed Alyami, Hussain Yahya Almansour , Faisal Salem S Alyami, Ibrahim Turki Hamel Alharith, Hassan Turki Hamel Alharith, Hassan Owaydhah Al Mansour, Hadi Hamad Hadi Balhareth
Abstract :
Background: Clinical decision-making is a critical component of prehospital emergency care, where emergency medical technicians (EMTs) and paramedics must frequently make rapid clinical judgments under conditions of uncertainty, limited diagnostic resources, time pressure, and environmental complexity. Decisions regarding assessment, treatment, triage, transport, referral, and non-conveyance may directly influence patient safety and subsequent clinical outcomes.
Objective: This systematic review aims to synthesize the available evidence on clinical decision-making among EMTs and paramedics in prehospital settings, with particular attention to factors influencing decision-making, decision strategies, barriers and facilitators, and implications for patient care and safety.
Methods: A systematic search will be conducted across major electronic databases, including PubMed/MEDLINE, CINAHL, Embase, Scopus, Web of Science, and PsycINFO. Quantitative, qualitative, and mixed-methods studies examining clinical decision-making among frontline prehospital EMS professionals will be considered. Study selection and data extraction will be undertaken independently by two reviewers. Methodological quality will be assessed using appropriate Joanna Briggs Institute critical appraisal tools. Owing to anticipated methodological and clinical heterogeneity, findings will primarily be synthesized using structured narrative and thematic approaches.
Results: Evidence will be synthesized according to clinician-related, patient-related, environmental, organizational, and technological factors influencing clinical decisions, together with reported decision-making approaches and patient-safety outcomes.
Conclusion: This review will provide an integrated understanding of how clinical decisions are made in prehospital EMS practice and identify factors that may support or hinder effective decision-making. The findings may inform EMS education, clinical governance, protocol development, decision-support systems, and future research.
Keywords: Emergency Medical Services; Emergency Medical Technicians; Paramedics; Clinical Decision-Making; Clinical Reasoning; Prehospital Care; Patient Safety; Systematic Review
Cite This Article:
Please cite this article in press Saleh Baraik S Al Awadh et al., Clinical Decision-Making Among Emergency Medical Technicians And Paramedics In Prehospital Care: A Systematic Review Of Influencing Factors, Decision Strategies, And Patient-Safety Outcomes.,. Indo Am. J. P. Sci, 2026; 13(09).
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