Clinical Practice

Neuroleptic malignant syndrome: a neuro-psychiatric emergency

While the pathophysiology of neuroleptic malignant syndrome is complex and not fully understood (Berman, 2011), experts agree it involves a marked, sudden reduction in central dopaminergic activity...

Use of cognitive aids in paediatric out-of-hospital cardiac arrest

A survey study of 39 EMS agencies across six states of the United States was carried out. The survey (Appendix A, online) was developed as part of a larger study examining preventable serious adverse...

Confidence levels of students before and after a minor illness/injury placement

Research by Credland et al (2019) addressed the need for non-ambulance placements within the paramedic programme, such as walk-in centres, minor injury units, cardiac assessment units and general...

Diagnostic accuracy of early warning system scores in the prehospital setting

This commentary aims to critically appraise the methods used within the review by Guan et al (2022) and expand upon its findings in the context of clinical practice..

Hyperventilation in cardiac arrest—a systematic review and narrative synthesis

This review followed a focused literature search of three databases—CINAHL, MEDLINE and ScienceDirect—from 1 January 2000 to 27 April 2022. Only human, adult, prehospital studies were included. Papers...

Prehospital use of the paediatric observation priority score

How is POPS currently used in a prehospital setting within one Welsh health board?.

Ethics part 3: paramedic distribution, or ‘the good, the quick, the cheap’

The fair distribution of finite resources or ‘goods’ is distributive justice in its simplest form (Campbell, 2017). Rawls is perhaps the most influential contemporary figure who presented a...

Managing ambiguity and uncertainty in clinical decision-making

When paramedics are uncertain about exactly what is going on with a patient, they should start with what they do know. Even when managing a very uncertain situation, practitioners often know more than...

ECG Case Series for Paramedics: April 2023

The heart rate is approximately 50 beats per minute and in sinus rhythm. There is left axis deviation..