College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
South Australian Ambulance Service, Adelaide, South Australia, Australia.
BMJ Open. 2020 Feb 28;10(2):e033447. doi: 10.1136/bmjopen-2019-033447.
The objective of this scoping review is to systematically map the literature to identify the scope, depth, key concepts and gaps in the evidence regarding care of the patient with invasive meningococcal disease by emergency medical service (EMS) clinicians.
Scoping review. This review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guideline.
Sources which focused on patients with invasive meningococcal disease (population), where the care of EMS clinicians was the focus (concept), in EMS systems worldwide (context) were eligible for inclusion.
This review utilised a comprehensive search strategy including MEDLINE, Embase, Emcare, CINAHL, Scopus, Web of Science, Google Scholar and 'grey' literature databases from 1992 to January 2019. The search also included a Google search, a hand-search of relevant journals, screening of reference lists, contact with authors of included sources and use of social media in an attempt to locate all sources of evidence which fit the inclusion criteria of the review. Two reviewers independently screened sources for inclusion.
The search yielded 1803 unique records, of which 10 were included in the synthesis. No original research papers were identified, with all sources classed as either clinical audit or text and opinion literature. The dominant concept throughout the literature is that early antibiotic therapy is critical in the treatment of invasive meningococcal disease.
Overall, there is a very narrow scope and shallow depth of literature on the topic of interest. There are gaps in the evidence regarding the care of the patient with invasive meningococcal disease by EMS clinicians. Despite these shortfalls, current consensus-based guidelines should direct clinical practice. Further research is planned to bridge the gaps in knowledge to support best practice.
本范围综述的目的是系统地绘制文献图谱，以确定有关急救医疗服务（EMS）临床医生对侵袭性脑膜炎球菌病患者护理的文献的范围、深度、关键概念和空白。
范围综述。本综述按照系统评价和荟萃分析扩展的首选报告项目对范围综述报告指南进行了报告。
符合纳入标准的来源重点关注侵袭性脑膜炎球菌病患者（人群），其中 EMS 临床医生的护理是重点（概念），并在全球 EMS 系统中（背景）。
本综述采用了全面的检索策略，包括 MEDLINE、Embase、Emcare、CINAHL、Scopus、Web of Science、Google Scholar 和“灰色”文献数据库，检索时间从 1992 年至 2019 年 1 月。检索还包括 Google 搜索、相关期刊的手工搜索、参考文献列表的筛选、与纳入来源的作者联系以及利用社交媒体试图找到符合综述纳入标准的所有证据来源。两名审查员独立筛选纳入的来源。
检索共产生 1803 条独特记录，其中 10 条被纳入综合分析。未发现原始研究论文，所有来源均归类为临床审计或文本和意见文献。整个文献中占主导地位的概念是，早期抗生素治疗对侵袭性脑膜炎球菌病的治疗至关重要。
总体而言，关于这一主题的文献范围非常狭窄，深度较浅。在 EMS 临床医生对侵袭性脑膜炎球菌病患者的护理方面，证据存在空白。尽管存在这些不足，但基于共识的现行指南应指导临床实践。计划进行进一步研究以填补知识空白，以支持最佳实践。
