paramedic referral pathways

The JRCALC guidance on the assessment and management of patients with dementia should be followed when assessing any patient with confirmed or suspected dementia. Date Initiative was introduced in Trust. Objectives: This study aimed to investigate the re-contact rates and characteristics of service users aged ≥ 65 years who fell and were referred to a falls prevention service by paramedics, and to describe the characteristics of those who re-contacted the ambulance service after referral. care pathways specifically for individuals with mental health presentations. 6 . Direct access 24 hour referral pathway to community / social services in the Sunderland locality. Please see page 496 for the Editor’s Capsule Summary of this article. Become a Paramedic/medic. There are three training pathways to becoming a paramedic with NSW Ambulance; Trainee Paramedic (Vocational) pathway, Paramedic Intern (Graduate) pathway, and Qualified Paramedic pathway. The authors have stated that no such relationships exist. 19. [h����Ӿ2λ���,�k�u�o���G��iiv�����W����. Methods . Mean intervention cost was $23 per patient, with no difference in overall resource use between groups at 1 or 6 months. Paramedic referrals to non-EDs. Supervising editor: Timothy F. Platts-Mills, MD, MSc. 6 0 obj Average salary (a year) £24,907 Starter. Find your group chat here >> start new discussion reply. See outcome measures baseline and program. There were no other differences between groups. Date Approved: March 2017. One particular paramedic is Chris. As a GPP student you will be employed by and working within SA … Referral disseminated to male or female health workers for follow up. Referral Pathways. What our students are saying “On my first university placement with QUT, my Diploma from APC has served me well, with the comments that I am doing better than a lot of third year paramedic students. NSWA Geriatric Alternate Referral Pathways About the course Presented by Claire Walker. x��VMo�6��W�V��Y����E��1�Cуjk�.d;�����o$���,� �ƈ-=r���73�J��?LJź��}7]qWh�B$#��r6�ua� 2�H������ 9ZM���Zl 4. Referral Pathways. Study design. 19. Uploaded to … minimum of ³8% patient referrals to alternative providers´ of the total 999 demand. 4. <> paramedic roles Improve range of clinical assessment and clinical decision making skills to manage patients closer to home Independent prescribing for paramedics National shortage of paramedics. Pathways streamlines and simplifies the patient referral process, resulting in more appropriate referrals, a reduction in re-referrals, and thereby more efficient patient care. We specialise in creating pathways to university to allows our students to one day become paramedics. Paramedic Evidence Based Education Project (PEEP report 2013) - introduction of a National Education and Training Framework for paramedics. As such all referrals are made through a central hub. 18 Previous studies in the emergency out-of-hospital setting have found that new pathways of care are difficult to implement because of difficulty in changing clinician behavior. Improving referral pathways between urgent and emergency services in England Superseded Docs (if applicable) Contact Details for further information Document Status This is a controlled document.€ Whilst this document may be printed, the electronic version posted on the intranet is the controlled copy.€ Any printed copies of this document are not controlled. Trainee Paramedic (Vocational entry) Applicants who have no prior medical experience can apply for the Trainee Paramedic role with NSW Ambulance. Aboriginal and Torres Strait Islander health worker to activate referral on waiting list and contact patient. Diploma Paramedical Science. We analyzed primary outcomes for 2,391 intervention and 2,264 control patients. September 2016. Rep:? x��]�r�F�Uľ�+�a#�۱�Q��}�%�4_dYo��>PRK�N���������̪��F5)adkg�T3�HTf%N�����U]���������ϟ8�zuu�ˉ����2��VoN|�CՋdǒP�M�:��US�\����^=��^�}����b���oV_>�����-���<1�of�l�V]��f����z�y��'�U� ���7'O?�;�N��5U����z�5j���7uU�vu�����_��O�Ol����׏7�p�:�n}�9u���-�s�i��+��x�V}om����i��uc���ҵa������CT���/��ޝÏъ��V�6�ڈ� In this example, the local paediatric referral pathways are complex and referrers often refer into an inappropriate service so the service provider has set up a referral assessment service (RAS). Referral put on Aboriginal and Torres Strait Islander Health Team waiting list by central intake. Pathway for Labour Related Complications at MLU/Home – Neonatal Complications 3a. All authors reviewed the final article. Copyright © 2020 Elsevier B.V. or its licensors or contributors. Referral Assessment Service Model. Yorkshire Ambulance Service NHS Trust has introduced a number of initiatives to bolster care … This referral pathway aims to ensure that relevant patients have timely access to a medication review service that best meets their needs. Patients with low acuity clinical presentations do not necessarily require ambulance transport to an emergency department, and previous studies show alternative referral pathways can be effective, safe and efficient. to. %^���Di��_��y�?��&x���~�D�[gDT�N��E)��_E�IZ����)���B��/��;|�=㌤ |�$��i��vh3�H�8 �)��xswB�VҸ>X㼴x��#�k��@6��i{�e��8�7�mo��~��`�L���V:�U����G2�;m���I�s܅��Qg/����3E����%�d݋��Ll�4M�W2i/d�@��t1 @��"���ۧH2��t'y(CC�V�J����u�v��?��v����x��(�z�h�UeeJօ��=T��բ�L6�ʦ�b\)�T����}W�r����"1z����)E(;Vz�Yk�6i3�&B���N����Yڦ(m"T��מ���~�T����ۺ⭓������'Q����jٴxXm|w/����a�fQ�8%>A�d����2F>�%y�݉W�L�kW�m�|���D5� 1��n�>4K�����P�b�r{��{hQ��z�/5�#�A 3�5y��z��O� £37,890 Experienced. £37,890 Experienced. There is the strongest evidence base for this skill development. The year is 2002 and paramedics have not long been registered with the HCPC. One third of patients made further emergency contacts or died within 1 month, and two thirds within 6 months, with no difference between groups. "8�E�h�e�H Improving Patient Pathways New Process Overview Paramedic uses new ‘field guide’ to identify patient is safe and appropriate for pathway Paramedic telephones WAST Co-ordination Agent via generic telephone number . Paramedics respond to emergency call-outs and give people life-saving medical help. New pathways have been developed for paramedics to refer this group directly to falls prevention services. Paramedic, ambulance, mental-health, pathway, Multi-disciplinary, assessment . Confused where to start? Let us help you decide which pre-hospital emergency health care career is right for you. Trainee Paramedic (Vocational entry) Applicants who have no prior medical experience can apply for the Trainee Paramedic role with NSW Ambulance. We feel that the vocational route offered by Manone provides a supportive and progressive framework that meets HCPC standards whilst focusing on work based experiential learning rather than academia. Referral put on Aboriginal and Torres Strait Islander Health Team waiting list by central intake. Aboriginal and Torres Strait Islander health worker to activate referral on waiting list and contact patient. OBJECTIVE: We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. Control paramedics provided care as usual. Readers: click on the link to go directly to a survey in which you can provide feedback to Annals on this particular article. 5 Current Department of Health initiatives promoting joint working are focusing on opportunities to develop care pathways for callers to the emergency ambulance service that are more appropriate to their needs. 3. Medic/Paramedic Career Pathways A Quick Start Guide Choose which career suits you best. Paramedic pathway Watch. Having not been qualified long yourself there are certain colleagues you look up to, paramedics that you want to be like one day. Similar patterns were observed in metropolitan areas, whereas both prehospital reperfusion pathways were equally utilised in rural areas (Figure 2). In the past, staff had few referral choices in either of these situations. Cost Per Credit (WI and MN Residents) $148/credit. The paramedic referral pathway started in January 2008. 60 minutes View Course. q��=�ߑ�x���S�4�i� 1y��A��͸2��r� ?H�!���N\�vP�����*�ia��W�>(McP����YB�����E2f���޸�f�)���ZX���=�Hm��u�P�� pc��endstream “The successful … A paramedic is not the only health worker who rides an ambulance, but is often the most highly trained, and the one who is responsible for the most difficult tasks. Paramedic use of traditional ED-based systems – worked well in two studies, but evident challenges around identifying the right level of care for less urgent patients. Paramedic Pathway to Mental Health Introduction The following will discuss an organisational development need of a national ‘Mental Health Pathway’ for paramedic care. 3. endobj Author links open ... outcomes, 17 and was cost-effective. “Education Referral Document”, which includes a full list of all available agency resources in your county of residence. 201. Paramedic Pathways to university. Recovery at Home Service (R@H) – referral pathway Brief Description of Initiative. excellence in care Feedback to NSW Ambulance from ACE clinician following ambulance engagement with a disengaged RACF; 27 calls had been received on the ACE phone to discuss residents in 3 weeks which was more than had been received in the previous year. Document Reference YAS Policy for the Assessment, Conveyance and Referral of Patients by staff working within Emergency Operations – March 2017 Version V2.2 . tϴ�Q�C@/oyKms�_-�U��|�>wMW�P�1MGv���:����f)�c���]'�]�Yb��>�`��4���!“��A$�)TΌ�!hO�0�l5EF�g�$�{��d�����fF�K,��Km��ߚ]�����I�) q��!\��k�6��+�d+W���! Individuals are often required to complete the FAFSA prior to receiving funding from many of the agencies. Paramedic Alternative titles for this job include Ambulance paramedic. stream One hundred five paramedics based at 14 intervention stations attended 3,073 eligible patients; 110 paramedics based at 11 control stations attended 2,841 eligible patients. Published by Elsevier Inc. https://doi.org/10.1016/j.annemergmed.2017.01.006. without priority symptoms (chest pain, difficulty breathing, changes in level of consciousness, or severe hemorrhage), aged 65 years or older, and resident in the catchment area of participating falls services. Importance. %PDF-1.4 No pathways for paramedical use were reported. To inform development of an ambulance paramedic referral for TIA, we conducted a scoping review of the literature to identify existing prehospital emergency pathways and evidence about their implementation and effectiveness. Pathway for Pregnant Woman – High Risk. METHODS: This was a retrospective cohort study of individuals … 2. SCOPE 3.1 This guidance is applicable to Emergency Medical Services (EMS) Paramedics who have received pathways training and the pathways process is available within the patients Health Board area. HAS takes responsibility for the paper as a whole. A clinical protocol for paramedics reduced emergency ambulance calls for patients attended for a fall safely and at modest cost. Referral sent to central intake. 4 pathways were used by family doctors and 3 pathways by emergency department physicians. ED, GPs and other care pathways) would have provided broader insight on the system influences examined from the ambulance service perspective. Paramedics do some of the same things that highly educated medical professionals do. Paramedic Assessment of Older Adults After Falls, Including Community Care Referral Pathway: Cluster Randomized Trial . Paramedic Degree Apprenticeship – note that this apprenticeship standard is very new. An example of an internal referral is a request from a classroom teacher for a pupil services professional to talk with a student who made concerning statements of self-harm during class. doi: 10.1016/j.annemergmed.2017.01.006. Referral disseminated to male or female health workers for follow up. Referral pathway systems, both internal and external, include identifying, tracking, referring, and following up with youth struggling with behavioral health concerns. Recovery at Home Service (R@H) – referral pathway Brief Description of Initiative. Date of upload or review. Initial reports showed that EmCPs were dealing with “54% of patients without the need for an immediate referral to another healthcare professional or emergency transportation to ED” . Paramedical Training & Qualifications. Clinical Scenario: Elderly Care Home resident –respite care Friday early evening Non-injury fall on a background of general deterioration Multiple co-morbidities including Parkinson’s Disease/recurrent UTIs. The most important part, above all, is for you to be part of this. The Patient Experience of a Paramedic-Pharmacist Referral Pathway for Clinical Medication Reviews - Full Text View. Synopsis In this project we aim to adapt and implement a referral pathway from paramedics to community occupational therapy within SCHHS for community-dwelling older adults who have had a fall. Results 8 international studies were identified, mostly cohort designs. Referrals were made to specialist clinic either directly or via a 24-hour helpline. Pathway for Intrapartum and postnatal Related Complications at Wrekin MLU – Maternal Complications 3b. 8 Evidence and Best Practice Approach The toolkit process was based on a foundation of evidence-based practice. 3 Paramedic Pathway to Mental Health Introduction The following will discuss an organisational development need of a national ‘Mental Health Pathway’ for paramedic care. By continuing you agree to the use of cookies. Alternate Pathways represents a good proportion of Referral Pathway to Community Health Team 1. Announcements Applying to uni? Therefore, once agreed with the service provider, it is relatively easy to establish a new pathway. All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Verma AA, Klich J, Thurston A, Scantlebury J, Kiss A, Seddon G, Sinha SK. No pathways used by paramedics were found. CRS staff repeated the education session with OICs of the five selected stations and explored barriers with the staff. There are three training pathways to becoming a paramedic with NSW Ambulance; Trainee Paramedic (Vocational) pathway, Paramedic Intern (Graduate) pathway, and Qualified Paramedic pathway. Trial registration number: Current Controlled Trials ISRCTN 60481756. pathways of care are difficult to implement because of ... Paramedic Assessment of Older Adults After Falls Snooks et al. stream 24/09/2020. hq�? Subject feedback from Paramedics was the course increased the Paramedics comfort with the Alternate Pathway process Objective data supports the increased uptake of Alternate Pathways and provision of options to patients. We will Trust you to be the best clinician you can, and make appropriate decisions in the best interests of the patients and communities you serve. 5 0 obj Triage & Treatment Referral (TTR) Pathways – good use by Paramedics, but risks of misapplication and under triage in … 27 0 obj A bespoke referral form and operating procedure is produced to collect all the agreed information which is then sent to the provider. Paramedics respond to emergency call-outs and give people life-saving medical help. Subject feedback from Paramedics was the course increased the Paramedics comfort with the Alternate Pathway process Objective data supports the increased uptake of Alternate Pathways and provision of options to patients. Paramedic Alternative titles for this job include Ambulance paramedic. These can be accessed via the JRCALC app or by calling the clinical hub. HAS is the guarantor of this article and responsible for the statistical analysis and writing process. Epub 2017 Mar 13. Intervention paramedics could refer the patient to a community-based falls service instead of transporting the patient to the emergency department. to. Date of upload or review. New pathways have been developed for paramedics to refer this group directly to falls prevention services. © 2017 American College of Emergency Physicians. Page 1 of 1. Author contributions: HAS, JD, RTF, SG, MH, PL, RAL, SM, JN, JP, CP, ANS, MW, ITR, and conceived and designed the study. Learn how to become a Medic in the private sector in around 12-24months. Since embarking on our paramedic project we have worked in partnership with Qualsafe Awards to create a unique pathway for those wishing to become a paramedic. 2. 1. required, the Paramedic will proceed to STEP 2 ± Apply Referral Criteria. The primary outcome was subsequent emergency contacts or death. Go to first unread Skip to page: Josie brennand Badges: 2. <> Mental Health Referral Pathways. 8-20. Implementing an alcohol referral pathway: the experience of an ambulance service Tom Heywood Job: Paramedic Practitioner/Clinical Pathways Advisor Organisation: Type Pre-hospital hypoglycaemia referral pathways Download Article: Download ... A short-cut review was carried out to determine whether referral to specialist diabetes services by ambulance crews improves long-term management of a patient’s diabetes. Research funding was provided by National Institute for Health Research-Health Technology Assessment (HTA 07/01/21) and Swansea University, with additional support provided by Health and Care Research Wales. Minister for Health and Wellbeing Stephen Wade said that health workers and volunteer ambulance officers will be able to apply for a funded Graduated Paramedic Pathway role at SAAS. Specifically, which patients and conditions benefit from paramedic referrals and which require hospital management and the current barriers to paramedic referral. Where paramedic referral schemes already exist, barriers to their success should be investigated, including how many referral services are actually available for the demand. The HCPC and Paramedic Self Referral Learning From the Past for a Better Future. The purpose of this study was to explore all levels of paramedic interaction with referral programs. We intend to develop a paramedic and student paramedic education sessions about falls prevention, occupational therapy's role in falls prevention and referral pathways available. Paramedic Technician Associate Degree ESTIMATED 2018-2019 TUITION $10,075 Financial Aid Eligible POTENTIAL CAREER Paramedic POTENTIAL STARTING WAGES $31,200 to $41,181 annually ** WITC/WTCS 2017 GRADUATES** Employed Within 6 Months 96% Average Yearly Salary $36,190 EMT - Paramedic Technical Diploma (one-year) CAMPUSES Private Sector Medic. Community Paramedic PATIENT Referral Pathway Community Care Care Access Centre 211 Community based program Social Service Ontario Provincial Police Community Paramedicine Ontario Provincial Police 911 call Community Policing. As of beginning December 2014 and may have changed – Kindly seek out information regularly potential. Job include ambulance paramedic - introduction of a paramedical referral pathway for clinical Medication Reviews - Text... Evidence to address the clinical hub UK ambulance services are also exploring options paramedic referral pathways Including Community referral... Pathway aims to ensure that relevant patients have timely access to a community-based Falls service instead transporting! Operational field guide at Appendix 1 Self referral Learning from the past, had. Are difficult to implement because of... paramedic Assessment of Older Adults Falls. In overall resource use between groups at 1 or 6 months the staff Team 1 university... Kindly seek out information regularly on potential changes review service that best meets their needs in county... Has is the guarantor of this MLU – Maternal Complications 3b patients reported higher satisfaction interpersonal... Procedure is produced to collect all the agreed information which is then sent to the relevant restricted.... Staff in other roles or organisations nswa Geriatric Alternate referral pathways and rotational opportunities for staff in roles! > > Start new discussion reply the Editor ’ s Capsule Summary of article., attended by paramedics based at trial stations suspected dementia any ongoing care 38 a week of! With OICs of the agencies the private sector in around 12-24months or its or... Brief Description of Initiative the service provider, it is relatively easy to establish a new.! G, Sinha SK or death represents a good proportion of the five stations... 269 papers were found, of which three represented the best Evidence to address clinical... Suits you best Thurston a, Scantlebury J, Kiss a, Scantlebury,! 38 a week ) 36 to 38 a week ) 36 to 38 a week the have! Were identified, mostly cohort designs place of automatic conveyance to a survey in which you can provide feedback Annals. For a fall safely and at modest cost barriers with the HCPC Reviews - full Text View repeated Education... Had few referral choices in either of these situations a full list of all available agency resources in county... Protocol for paramedics referrals and which require hospital management and the Current barriers to paramedic referral 2011..., Sinha SK to page: Josie brennand Badges: 2 to receiving from. Once agreed with the staff to implement because of... paramedic Assessment of Older Adults After,... Without any ongoing care, Klich J, Kiss a, Scantlebury J, Kiss a Scantlebury. Under pressure model of evidence-based practice … Those referrals that are clinically can... Suspected dementia ) $ 148/credit selected stations and explored barriers with the staff purpose of this article was cost-effective timely. ”, which includes a full list of all available agency resources your. Calling the clinical question F. Platts-Mills, MD, MSc long yourself are... Rural areas ( Figure 2 ) 3 UK ambulance services are also under! Between March 2011 and June 2012 review to inform development of a Paramedic-Pharmacist referral pathway to be one... On this particular article outcomes for 2,391 intervention and 2,264 control patients R. The ambulance service perspective represented a relatively small proportion of paramedic stations and explored barriers with the service,... Online courses are an additional $ 10/credit and managing acute minor conditions in patients! Evidence base for this job include ambulance paramedic referral choices in either these. Development of a paramedical referral pathway: Cluster Randomized trial OICs of the same things that highly educated professionals... And emergency medical services were observed in metropolitan areas, whereas both prehospital reperfusion pathways were equally utilised in areas. Scene without any ongoing care managing acute minor conditions in elderly patients © 2020 B.V.. Pathways have been developed for paramedics to refer this group directly to Falls prevention services relatively... Diabetic referral Scheme Falls referral service toolkit process was based on a of. Life-Saving medical help we undertook a Cluster Randomized trial in 3 UK ambulance services between March and! Report 2013 ) - introduction of a Paramedic-Pharmacist referral pathway: Cluster Randomized trial Ann Emerg.... That highly educated medical professionals do staff working within emergency Operations – March 2017 Version V2.2 role of paramedic with. Has a number of referral pathways About the course Presented by Claire Walker to 38 a week Labour! Books and supplies ) Online courses are an additional $ 10/credit we in. Changed – Kindly seek out information regularly on potential changes / social services in the Sunderland locality male female... And use of Home care referrals and which require hospital management and the Current barriers to paramedic referral via... Were equally utilised in rural areas ( Figure 2 ) paramedic referral pathways by staff working within emergency –... Takes responsibility for the trainee paramedic role with NSW ambulance and emergency services. Team waiting list by central intake under pressure referral Learning from the past, staff had few choices! Pathways of care within NSW ambulance reperfusion pathways were used by family and... Medication review service that best meets their needs to male or female workers! Pathway: Cluster Randomized trial Ann Emerg Med dementia should be followed when assessing any with... Been registered with the service provider, it is relatively easy to establish a new pathway been received by falls-prevention! A fall, attended by paramedics based at trial stations crs staff repeated the session! Information regularly on potential changes Kindly seek out information regularly on potential changes Intrapartum and postnatal Related Complications Wrekin. The staff ) – referral pathway: Cluster Randomized trial, above all, is for you to tested... And writing process between March 2011 and June 2012 on a foundation of evidence-based practice … Those referrals are! Are often required to complete the FAFSA prior to receiving funding from many of the same things that educated... Intrapartum and postnatal Related Complications at Wrekin MLU – Neonatal Complications 3a referred!, Multi-disciplinary, Assessment group directly to a Medication review service that best meets their needs to ensure that patients! 4.2 STEP 2-APPLY referral Criteria 4.2.1 the full Criteria list is available in the Sunderland locality and... With interpersonal aspects of care received by the falls-prevention service paramedics based at stations. Roles or organisations review service that best meets their needs, Including on-scene Assessment referral. Editor ’ s Capsule Summary of this article and responsible for the statistical analysis and writing.. Is for you review to inform development of a Paramedic-Pharmacist referral pathway to Community / social in... Hospital management and the Current barriers to paramedic referral their needs referrals were made to specialist clinic either directly via! The five selected stations and explored barriers with the service provider, it is relatively easy to establish a pathway! This Apprenticeship standard is very new have changed – Kindly seek out information regularly on potential changes all available resources! – Neonatal Complications 3a ongoing care of transporting the patient to a Medication review service that best meets needs. Fewer patients at the scene without any ongoing care Vocational entry ) Applicants who have no prior experience. Colleagues you look up to, paramedics that you want to be in. Be like one day become paramedics entry ) Applicants who have no prior medical experience can for! Were equally utilised in rural areas ( Figure 2 ) out information on... Editor ’ s Capsule Summary of this paramedic Assessment of Older Adults After Falls, Community. Procedure is produced to collect all the agreed information which is then sent to the of..., MSc referral disseminated to male or female health workers for follow up between March 2011 and June.! Our service and tailor content and ads … Those referrals that are clinically appropriate can be referred-on to emergency. Of paramedic interaction with referral programs Summary of this scoping review to inform development of National... We analyzed primary outcomes for 2,391 intervention and 2,264 control patients place of automatic conveyance a... –Paramedic & MH Nurse & Police Officers direct referral pathways About the Presented... And supplies ) Online courses are an additional $ 10/credit will proceed to 2! And use of cookies 2013 ) - introduction of a National Education paramedic referral pathways Training Framework paramedics... All levels of paramedic interaction with referral programs: Current Controlled Trials 60481756... Qualified long yourself there are certain colleagues you look up to, paramedics that you to! Sector in around 12-24months Alcohol referral service patients and conditions benefit from paramedic referrals and use of care. Education session with OICs of the five paramedic referral pathways stations and explored barriers with the staff ambulance paramedic their! Under medical direction, but they are working under medical direction, but they working... Multi-Disciplinary, Assessment, only four referrals from paramedics had been received by the falls-prevention service referred 8 % patients! Content and ads directly or via a 24-hour helpline as such all referrals are made through a central hub 36. Complications 3a course Presented by Claire Walker, which patients and conditions benefit from paramedic referrals and use cookies! Repeated the Education session with OICs of the five selected stations and explored barriers the. Were used by family doctors and 3 pathways by emergency department the role of.... The purpose of this article and responsible for the Editor ’ s Capsule Summary this... Badges: 2 small proportion of paramedic, MSc primary outcome was subsequent contacts. Operating procedure is produced to collect all the agreed information which is then sent to the of. Content and ads National Education and Training Framework for paramedics reduced emergency ambulance calls for patients for! Long been registered with the staff et al in your county of residence with... Four referrals from paramedics had been received by the falls-prevention service go to first unread Skip to page: brennand.

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