Ambiguity and uncertainty are unavoidable elements of clinical practice. Although they can cause discomfort for both clinicians and patients, they can also be used to positive effect ensuring safer clinical practice that is tailored to individuals. As paramedics generally work in areas of practice where they encounter undifferentiated complaints with limited resources to investigate, diagnostic uncertainty can prove a challenge on a regular basis. Similarly, even when paramedics are fairly confident of the diagnosis, optimal management is frequently unclear or unachievable. This article presents practical short-term strategies to manage both diagnostic and management uncertainty in clinical practice. This article also suggests longer-term tactics that can be developed individually and collectively beginning with developing capability over competence through to changing culture and providing space for supervision. While these strategies may not completely eliminate the discomfort that can arise when faced with ambiguity and uncertainty, they can enable a greater tolerance for it, improve clinical practice, and ultimately benefit patients.
The only practical CPD journal for paramedics
- Clinical articles
- Case Studies
- CPD Focus
About Journal of Paramedic Practice
Journal of Paramedic Practice (JPP) is the only monthly peer-reviewed journal dedicated to the clinical and professional needs of paramedics. It is a vital resource for helping paramedics enhance their professional knowledge and stay ahead of all their continuing professional development (CPD) requirements.
Achieve your CPD with JPP We offer a programme of 12 online reflective practice CPD modules per year. In consultation with experts, the online CPD modules will aim to cover core topics of practice relevant for paramedics, including the key area of pharmacology. Website subscribers can access our latest and archive modules, a selection of which can be found below. Subscribe Today
buccal midazolam and rectal diazepam are used as first-line drugs to control seizures in children. Immediate treatment and management of a continuing seizure is vital to ensure its safe, effective and prompt termination.
Despite concerns over their side effects, short-acting beta-2 agonists are still used in high doses in prehospital care internationally to treat asthma exacerbations. This systematic review set out to identify the physiological effects associated with this treatment and determine their potential impact on the patient's presenting or underlying conditions.
Stroke is a significant clinical event and a medical emergency. More than 100 000 individuals in the UK experience a stroke annually, with one in four strokes occurring in people of working age. Stroke care costs the UK economy £25.6 billion a year. Evidence suggests that 90% of strokes are preventable, and there are some key modifiable risk factors. Stroke assessment and management are improving, with new pharmacological and surgical treatments, including mechanical thrombectomy. Recent advances in the use of technology and artificial intelligence for rapid radiological interpretation to aid decision making are fundamentally improving stroke management. A strategic stroke framework was launched in 2021, with the aim of improving care throughout the whole stroke pathway from prehospital management to rehabilitation and recovery. This paper outlines the aetiology of acute stroke in adults, related conditions, risk factors, assessment, treatments and financial implications, and discusses the new frameworks for stroke care as they apply to prehospital practice.
The paediatric assessment triangle (PAT) is an internationally accepted tool in paediatric life...
This article outlines changes that have been made to the patient assessment primary survey for...
Traumatic cardiac arrest (TCA) is a rare event in the pre-hospital setting and has a varied...
Paramedic practice is progressing at a more rapid pace now than at any time in its history....
What our readers say
- Wednesday, November 2, 2022
Background: Chest compressions are one of the few interventions proven to improve survival from...
Leadership and management
- Saturday, July 2, 2022
Background Mental ill health among ambulance staff is widespread. Evidence suggests that, with the...