This book states that it is aimed at both paramedics who are new to the world of primary care and those who are already working within a primary care environment.
The authors clearly have a wealth of experience in primary care and the prehospital setting, which are equally important when writing about paramedic care in the primary care setting. Alongside the three authors, there are no less than 19 contributors, again representing some crucial clinical areas such as midwifery, end-of-life care, education, and safeguarding. Before you even get into the hefty 500+ page book, this wide range of expertise has the effect of giving you confidence in the quality of the content.
We are firstly provided with a ‘How this book works’ section which provides the reader with some useful tips on areas, which cover the clinical rules, red flags and clinical pearls. I do find these reader tips useful, especially with larger clinical books such as this. They allow the reader to skip around to topics, using the book as a point of reference, even when time is short, such as while in clinical practice.
As you would expect, chapter 1 covers a number of areas for the paramedic to consider in relation to their profession. The basics of infection prevention and control (IPC) are covered, which shouldn't be new information to a practising paramedic. However, it was good to see four pages dedicated to work-related stress—a refreshing acknowledgement of a subject which is often overlooked.
Patient relationships
We are then moved straight into consultation and decision-making. These skills are described as the scaffolding on which to build a working relationship with the patient—something I couldn't agree with more. There are various models explained, all of which add useful elements to building your own consultation skills and creating the method that feels right to you and suits your own personal style.
To the laboratory
We are then taken through what feels like a rather swift overview of laboratory results, particularly for the length of the book. I would have expected a more in-depth exploration of analysing blood results. Given that this is an area which sits firmly within primary care, and one which prehospital paramedics don't tend to venture into and will likely be a brand-new skill, it feels too brief. A mere 30 pages to cover the intricacies of a full blood count, inflammatory markers and urea and electrolytes, only serves to provide an overview.
For a paramedic working in primary care who would be expected to order blood tests, analyse them and use them to formulate a working diagnosis, there just isn't adequate depth to this subject. It does provide a nice overview but with only one case study to test your knowledge; be prepared to go out and purchase another book focusing specifically on this subject if this is going to form part of your role.
Systems and conditions
The remaining chapters flip between systems, such as neurological, cardiovascular and respiratory, to specific condition overviews such as mental health, obstetric presentations and palliative care.
As you can imagine, there is a huge amount of information that this book is attempting to cover. The result is a slightly disappointing overview of all of these subjects. It doesn't feel like it gets to the depth needed for a paramedic to confidently work in primary care. It certainly wouldn't be a book I would be referring to while in practice as there just isn't the level of information required for reference.
For example, there are no illustrations within the dermatological chapter. This is an area which again wouldn't normally feature heavily in a paramedic BSc course; therefore, wouldn't be an area of confidence for most paramedics. A few pictures would be really useful to help navigate the confusing ‘maculopapular’ world.
In summary
This book begins well, covering specific areas that would benefit many paramedics. The art of consultation, in particular, and the mastery of this subject allows paramedics to gain a lot of insight into the patient's presentation. This skill would be recognised as beneficial in both primary care and the prehospital world.
As the book progresses, however, too much is covered, resulting in a lack of depth and detail. If you intend to work in primary care you will need to invest in some wider reading material to supplement this text.
Three Key Takeaways
- This book provides some useful information including a refreshing look at work-related stress, and a chapter on consultation and decision-making as the basis of the paramedic-patient relationship
- This book provides an overview of laboratory results, as well as areas such as mental health, obstetrics, dermatology and palliative care
- This book attemps to cover a wide array of subjects and is unable to provide the depth required into each for a paramedic's foray into primary care without supplementary reading