Background: Prehospital emergency care means to respond to patients’ life-threatening and critical medical conditions out of hospitals. Patients experience this as an existential suffering together with a physical suffering. Thus a need of combining the medical care and treatment with a caring science perspective in order to provide a lifeworld-led care is stated.
Aim: The aim was to develop a model for application of a lifeworld-led prehospital emergency care.
Method: The model was developed using Paul Ricoeur’s hermeneutical philosophy, bringing together the concepts explanation (EXP) and understanding (AND).
Results: The EXPAND-model comprises the three phases; 1) primary understanding, 2) structural explanation and 3) secondary understanding that together integrate medical care with a lifeworld perspective on the patient’s illness/injury. The primary understanding refers to the intuition and first impression of the patient as a person and his/her multifaceted needs, adapting to the patient and his/her surroundings. The structural explanation belongs to the emergency medical assessment and care using different structural systems. This aims to quickly identify and provide care for life-threating conditions. In the secondary understanding the primary understanding and the structural assessment are brought together into a whole, creating a comprehensive understanding of the patient’s lifeworld as intertwined with his/her illness/injury.
Conclusion and implications: In the EXPAND-model the three phases cooperate in order to expand the assessment and care of the patient, based on a lifeworld perspective. The implication of this is two folded. Firstly, this is of importance in order to develop a lifeworld-led prehospital emergency care, which goes beyond fixed medical diagnosis. Secondly, the model may structure the training of professionals to unfold the uniqueness of a person’s experience of illness/injury in relation to a complex world and the existential aspects of being human.