The Role Of Nurses And Paramedics In Improving Continuity Of Care From The Scene Of The Accident To The Emergency Department

Abstract

Traumatic injuries and accident-related emergencies remain among the leading preventable causes of morbidity and mortality worldwide. The critical period extending from the scene of the accident to arrival at the emergency department (ED) plays a decisive role in determining patient outcomes. During this complex transitional phase, optimal care depends not only on timely life-saving interventions, but also on the effective maintenance of continuity of care, defined as the coherent transfer of clinical information, decision-making, and professional responsibility across the emergency care continuum.

Contemporary models of prehospital emergency medicine emphasize that the effectiveness of emergency medical services (EMS) should be assessed not merely by response times, but by their capacity to sustain an integrated chain of care linking prehospital and in-hospital emergency services. International guidance highlights that strong organizational, clinical, and informational integration between paramedics and emergency departments is essential for improving patient safety and outcomes.

Despite these advances, the transition of care between paramedics and emergency department teams remains a vulnerable point in trauma and emergency pathways. Time pressure, environmental complexity, and communication variability frequently result in the loss of critical information, including evolving vital signs, prehospital interventions, medication histories, and mechanisms of injury. Such gaps can compromise triage accuracy, delay definitive management, and disrupt continuity of treatment within the ED.

To address these challenges, international trauma and emergency care guidelines advocate for the standardization of handover processes, including the use of structured communication tools such as SBAR, MIST, and IMIST-AMBO. These frameworks aim to reduce interprofessional variability, enhance the completeness of transferred information, and promote shared situational awareness between prehospital and hospital teams.

Within this context, effective collaboration between nurses and paramedics is fundamental to ensuring continuity of care from the accident scene to the emergency department. Paramedics provide a comprehensive prehospital clinical narrative, while emergency nurses play a pivotal role in translating this information into triage decisions, activation of clinical pathways, and coordination of multidisciplinary resources. When continuity of care is conceptualized as informational, managerial, and relational continuity, the nurse–paramedic interface emerges as a key determinant of care quality and patient safety.

Accordingly, this study, entitled “The Role of Nurses and Paramedics in Improving Continuity of Care from the Scene of the Accident to the Emergency Department,” addresses a high-risk transition point within emergency care systems. By examining interprofessional roles and communication processes, the study seeks to contribute evidence-based insights that support safer handover practices, enhanced continuity of care, and improved outcomes in modern emergency medicine.