PP20 Challenges and strategies in paramedic training for the RAPID2 trial of FICB for hip fractures

<h3>Background</h3> The NIHR HTA funded RAPID2 trial aims to test the safety, clinical and cost-effectiveness of paramedics providing pre-hospital fascia iliaca compartment block (FICB) pain relief for patients with suspected hip fracture. FICB is not routinely available in pre-hospital care but may improve patient outcomes through better pain relief and avoiding morphine side effects. However, training paramedics in FICB is not straightforward. RAPID2 seeks to train 160 paramedics across four sites. This poster will outline some of the strategies employed, challenges encountered, and reflections of research paramedics involved. <h3>Methods</h3> Challenges encountered: Co-ordinating hospital and ambulance service staff availability with FICB training opportunities. Increased service demand during the training period, resulting in increased fatigue and reduced morale. Staff withdrawal due to career progression/secondment opportunities. Other commitments competing for staff time. Approaches used: Training was coordinated by RAPID2 site research paramedics and hospital PIs, employing strategies as follows. Increasing training opportunities by recruiting multiple anaesthetists to support trial training. Regular face-to-face contact from RAPID2 Research Paramedics at each site, including ‘drop in’ sessions and refresher training. Promotion of the rationale for the trial and the benefits it may bring to patient care, alongside the opportunity to enhance skill sets. Providing CPD hours and overtime payments for time spent undertaking RAPID2 training. Providing training sessions on different days and at different times to allow hospital and ambulance staff to carry out training at a time that suits them. <h3>Results</h3> The trial was well received, with 150 expressions of interest gained from paramedics across sites, most of whom have begun training. <h3>Conclusion</h3> By adapting to circumstances and employing a range of engagement and promotion strategies, paramedic engagement with training has improved. These strategies could be adopted in other trials.