Determining patient eligibility in a rapidly changing clinical setting (TDF beliefs about consequences)
Linked to the hesitancy in delivering the REBOA intervention in a future trial as emphasised above, the challenges associated with determining patient eligibility in relation to the rapidly changing clinical setting was also noted. For example, the clinical picture of the patient in a pre-hospital setting often changes quickly, which means that patient eligibility to participate in a trial could be fluid and changeable. Participants reported that assessing eligibility required a level of flexibility and attentiveness to the status of the patient. This was particularly notable in the pre-hospital environment, which was described as dynamic and unpredictable, a factor which could also affect clinician confidence to determine patient eligibility and perform REBOA out with the hospital in a future trial.It’s very fluid, it’s very dynamic, there’ll be certain situations where you start down a trajectory or a path of treatment and actually when you’ve reassessed, not that it’s incorrect, but actually that path slightly changes and they might respond well to something that then stops you on that path or just slows you down that path… Paramedic, participant 3.