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.

Latest CPD

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

Respecting an autonomous decision to refuse life-saving treatment: a case study

Autonomy is a key principle in biomedical ethics, giving patients the right to be involved in their own care. Professional autonomy allows paramedics to make critical decisions around patient care in an emergency, enabling them to provide life-saving treatment. A patient's autonomy can conflict with that of a paramedic, leading to complex ethical challenges, which can affect the way a paramedic performs their duty of care. An autonomous patient has the right to refuse treatment, creating ethical challenges for paramedics. An autonomous patient's decision to refuse treatment, even if it may seem unwise, must be respected in accordance with the Human Rights Act 1998.

Applying organisational behaviour theory to aid emergency staff retention

The purpose of this theoretical concept article is to spark a dialogue on the use of organisational behaviour theory to address emergency responder retention. In the United States, emergency medical services (EMS) appear to be burdened with continuing problems of retaining staff. Poor responder retention affects the ability of EMS to deliver high-quality services; without trained, educated and experienced first responders, the EMS system struggles, and what suffers is the ability to provide medical care. The authors set out to construct a pathway for addressing the underlying issues leading to the exodus of professionals using organisational behaviour theory. To develop the idea, an inductive logic approach was used to address underlying negative factors influencing poor retention and discuss the promise of organisational behaviour theory in improving the retention of responders.

Excited delirium syndrome

Mental health calls make up a large proportion of ambulance workloads, with paramedics responding to a wide range of presentations such as anxiety, depression, bipolar disorder, schizophrenia, and excited delirium syndrome. Excited delirium syndrome is an increasingly common presentation, characterised by extreme agitation and aggression in a patient with an altered mental status. Excited delirium is a potentially life-threatening condition, with generally non-specific symptoms. Common triggers of excited delirium syndrome are acute drug use, psychiatric illness, or abrupt cessation of antipsychotic medication. It occurs when there is excessive dopamine stimulation in the striatum, combined with acute exposure to catecholaminergic psychoactive substances. A history of schizophrenia, or bipolar disorder are known risk factors for excited delirium syndrome. While agitation and aggression, concomitant with an altered mental status are the hallmark of excited delirium, other medical conditions such as hypoxia, head trauma, hypoglycaemia, hyperglycaemia, and infection can produce similar symptoms, and need to be ruled out as causes. Safety is paramount in the management of excited delirium, with the use of physical and chemical restraint being commonplace. Rhabdomyolysis often occurs when the patient is able to exercise extreme exertion against the restraints and this should be minimised to prevent the risk of cardiac arrest.

Assessment of women during early pregnancy

Approximately 5% of the workload of UK emergency ambulance services involves managing obstetric patients. This places pregnancy firmly within the scope of prehospital care, but training often focuses on critical illness during pregnancy rather than the range of presentations seen. This review aims to discuss the implications of early pregnancy with a focus on ectopic pregnancy, rhesus incompatibility, miscarriage and hyperemesis gravidarum. Normal presentations of pregnancy and alternative management strategies, including early pregnancy units, are also discussed.

What our readers say

“Journal of Paramedic Practice is an essential reference tool for the practising paramedic. Not only does it keep you up to speed with clinical best practice (focused on the topics you need to know), but its online CPD modules make it easy to carry out your required learning whenever is convenient.”