Clinical Practice

Recognising ECG landmarks

Electrocardiograms (ECGs) have become an integrated part of an ambulance clinician's toolkit, with thousands being performed each year (Brady et al, 2012). Invented in 1903 by Willem Einthoven, a...

A brief guide to borderline personality disorder in an emergency setting

OverviewParamedics and ambulance staff are frequently in contact with patients who have mental health diagnoses This may be the primary reason for contacting the emergency services (e.g. self-harm,...

Point-of-care ultrasound use in the pre-hospital setting

Since its introduction, POCUS has been used to enhance the assessment of a wide range of clinical conditions across medical and traumatic pathologies. For example, the ‘focused assessment with...

Measuring blood pressure and monitoring patterns

Systolic pressure is the force of BP on arterial walls at the end of ventricular contraction, i.e. in systole (Tortora and Derrickson, 2017). Diastolic pressure is the force exerted by the remaining...

GP perspectives of paramedic referrals to urgent and primary care

Ethical approval for the current study was sought and obtained with further support from the researcher's employers. Initial contact (via email) then commenced with an administration team, in which...

Best practice technique in intramuscular injection

In this month's Clinical Skills article, best practice for the administration of intramuscular (IM) injections will be discussed. It is important to re-visit clinical skills as many are taught during...

Hand hygiene compliance in the pre-hospital setting

Health professionals' compliance with hand hygiene remains a universal problem in health care (Gould et al, 2017; Sunley et al, 2018). While poor hand hygiene is prevalent in the inpatient and...

Using haemostats effectively in pre-hospital care

The purpose of this month's Clinical Skills column is to provide safe and effective best practice guidance for the use of haemostatic agents, or haemostats, in the pre-hospital environment. The topic...

Traumatic cardiac arrest: what's HOT and what's not

Treatment and management is increasingly being directed at the rapid identification and reversal of potential causes. Reversing hypovolaemia, oxygenation and tension pneumothorax (HOT) as a priority...

Intraosseous access: a safe alternative route

IO infusion is a method of administration of medications or fluids directly into the marrow of a bone (Figure 1)..

Capnography: monitoring CO2

The content of the air we breathe is a mixture of gases, with each gas exerting a pressure dependent on its proportional size. This is called its partial pressure and is abbreviated as the letter ‘P’,...

Pre-hospital management of major haemorrhage following trauma: part one

Bleeding within the body affects two principal physiological systems:.