In-Home Management of Skin Tears by Community Paramedics: a case series report from a novel pilot intervention

Abstract Background: Skin tears are common in older adults, particularly those who are frail or experiencing age‑related skin changes. In rural and remote regions, limited access to timely wound care can lead to delayed assessment, infection, prolonged healing, and preventable emergency department use. Community paramedicine programs have emerged as a strategy to address these gaps by providing timely, in‑home care. This case series evaluates a rural pilot program in which community paramedics managed skin tears from initial presentation through healing. The study examined feasibility, clinical effectiveness, and system‑level impact in a region with limited home‑care capacity. Methods: A nine‑month retrospective case series was conducted in Renfrew County, Ontario. Patients referred for community‑paramedic assessment and management of skin tears were included. Data from electronic patient care reports and quality reviews captured referral source, time to assessment, wound characteristics, interventions, need for escalation, healing duration, and resource use. Descriptive statistics summarized demographics, timelines, and outcomes. Program enablers and challenges were identified through chart review and provider feedback. Results: Community paramedics managed 43 skin tears in 39 patients (mean age 87). All were assessed within 24 hours of referral, and 79% within 24 hours of injury. Hospital transport was avoided in 46% of encounters, and EMS activation was prevented in 51%. Only 10% required referral to specialized wound care. Among wounds followed to completion, mean healing time was 22 days with an average of 1.8 dressings per case. Challenges included exudate management and coordination across dispersed care teams. Conclusions: Community paramedics can safely and effectively manage skin tears in the home, improving access and reducing reliance on emergency services in rural settings. This model offers a scalable, patient‑centered approach to enhancing rural wound care capacity.