Satchell, EillishGott, MerrynJuhrmann, MadeleineDicker, BridgetAnderson, Natalie Elizabeth2025-12-102025-12-102025-06-26Australasian Emergency Care, ISSN: 2589-1375 (Print); 2588-994X (Online), Elsevier, 28(4), 294-299. doi: 10.1016/j.auec.2025.06.0042589-13752588-994Xhttp://hdl.handle.net/10292/20370BACKGROUND: Ambulance personnel play an important role in supporting families during death, dying, and bereavement. Evidence-based clinical practice guidelines are crucial for ensuring high-quality ambulance care. However, it is unknown what guidance currently informs care of bereaved families. This document analysis examines ambulance guidelines pertaining to family care in out-of-hospital death in Australia and Aotearoa New Zealand. METHODS: Clinical practice guidelines were sourced from all Australian and Aotearoa New Zealand ambulance services. Using qualitative document analysis, guidance addressing family care during death, dying, and bereavement was examined. Analysis was conducted using a customised coding framework informed by the Australian National Consensus Statement: Essential Elements for safe and high-quality end-of-life care. RESULTS: While most guidelines included essential elements of end-of-life care, there was significant heterogeneity in the scope, detail and nature of guidance. Care instructions varied between services, populations and clinical scenarios. Guidance pertaining to culturally safe care was limited. CONCLUSIONS: Ambulance clinical guidance remains focused on technical skills during resuscitation, death, and dying. More guidance is needed to inform important elements of family care such as communication, family partnership, and cultural safety. Incorporating evidenced-based principles of end-of-life care presents an opportunity to improve ambulance support for bereaved families.© 2025 The Authors. Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/BereavementDeathFamilyParamedicinePractice Guidelines4203 Health Services and Systems32 Biomedical and Clinical Sciences3202 Clinical Sciences42 Health SciencesHealth ServicesClinical Research7.2 End of life careGeneric health relevance1110 Nursing1117 Public Health and Health ServicesNursing3202 Clinical sciences4203 Health services and systems4205 NursingHumansAustraliaNew ZealandAmbulancesBereavementEmergency Medical ServicesQualitative ResearchFamilyTerminal CarePractice Guidelines as TopicGuidelines as TopicDocument AnalysisHumansTerminal CareBereavementFamilyQualitative ResearchAmbulancesEmergency Medical ServicesAustraliaNew ZealandGuidelines as TopicPractice Guidelines as TopicDocument AnalysisHumansAustraliaNew ZealandAmbulancesBereavementEmergency Medical ServicesQualitative ResearchFamilyTerminal CarePractice Guidelines as TopicGuidelines as TopicDocument AnalysisJournal ArticleOpenAccess10.1016/j.auec.2025.06.004