Paediatrics in paramedicine: bridging gaps in confidence, and education for optimal prehospital care

Trauma remains a leading global cause of morbidity and mortality, with paediatric trauma accounting for approximately 950,000 incidents and nearly 8% of all paediatric deaths annually. Managing critically ill paediatric patients (CIPP) requires technical skill, clinical competence, managing CIPP’s and emotional resilience, particularly in out-of-hospital settings. This multi-phase mixed-methods research investigated the preparedness of paramedics (including students) to manage CIPP through a literature review and four 2. interconnected studies. A scoping review of 22 studies identified limited exposure, emotional stress, training gaps, and systemic barriers as key factors undermining confidence and competence in paediatric care, with simulation-based training (SBT) and structured education highlighted as effective strategies. Study 1: A qualitative content analysis of 19 accredited Australian paramedicine programs revealed substantial variation in paediatric-specific content, with between 3% and 25% of total coursework dedicated to paediatrics. Study 2: A cross-sectional survey of 89 final-year paramedic students examined self-reported comfort, confidence, competence, managing CIPP’s and feelings, finding moderate to high comfort, confidence, competence and feelings and a significant positive correlation between competence and comfort (rho=0.483; p