Background: The coronavirus pandemic (COVID-19) has focused attention on healthcare workers’ concerns about working during a pandemic, however research on the topic has primarily been conducted in hospitals, with limited research specifically on paramedic workforce. This study critically examines and synthesises what is known about paramedics’ experiences of barriers to, and enablers of, responding to suspected or known COVID-19 cases.

Methods: An integrative review of the literature was undertaken using articles found by a systematic search of four research databases. Inclusion criteria included paramedics or emergency medical technicians who had experience of barriers to, or enablers of, responding to patients during the COVID-19 pandemic. A quality assessment of included articles was conducted.

Results: Nine articles, reporting on studies conducted in eight countries, met the inclusion criteria. Barriers to caring for potential or actual COVID-19 cases included communication and poor leadership, fear of infection to self and family, frequent changes in guidelines and inconsistencies across agencies, stress/burnout, and concerns with personal protective equipment. Enablers included job security, perceived social support, solidarity with other paramedics, and use of modern technologies for communication.

Conclusions: While some of the findings parallel those reported by other healthcare workers in hospital settings during COVID-19, paramedics working in the pre-hospital environment had unique experiences of caring for suspected or known COVID-19 cases that provide learnings to improve support for paramedics in these situations. These specific unique experiences, and the support required for paramedics will be discussed.