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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

Prehospital triage tools in major trauma: a critical appraisal of a systematic review

Effective triage is critical to ensure patients suffering major trauma are identified and access a pathway to definitive major trauma care, which is typically provided in a major trauma centre as part of an established major trauma system. The prehospital triage of trauma patients often relies upon the use of major trauma triage tools; this commentary critically appraises a recent systematic review that sought to evaluate and compare the accuracy of prehospital triage tools for major trauma.

Headaches in emergency and urgent care

Headaches are a common disorder, are the fourth commonest reason for attending an emergency department (ED) and account for around 1% of 999 calls. They are often poorly managed. Paramedics will encounter patients with headache disorders regardless of where they work. These presentations, however, can challenge clinicians because of the complexities of assessment and the potential repercussions of missing a significant pathology. The vast majority of headaches that present to the ED are primary migraines. Nonetheless, paramedics need to be aware of the potential for sinister causes; around 0.5% of sinister headache pathologies are missed at first presentation. This article gives an overview of headache categorisation and diagnosis, discusses the characteristics of migraines given their prevalence, and outlines how to assess and manage patients in emergency and urgent care settings.

Identifying and managing hyperkalaemia in the prehospital environment

Hyperkalaemia is defined as a high level of potassium within the blood. Potassium concentration is normally tightly regulated at 3.5–5.5 mmol/litre. Hyperkalaemia can have major consequences for muscle, nerve and cardiac function, leading to arrhythmias and cardiac arrest. It has many causes, including disease states, trauma and medication; a tourniquet can lead to pseudohyperkalaemia. Some patients are at a greater risk of developing it. Hyperkalaemia is most accurately identified through blood tests but results of these may not be available prehospitally. Paramedics need to take a thorough history and carry out an electrocardiogram (ECG) to diagnose hyperkalaemia. ECG results can indicate the severity of the condition, and a guide to the ECG changes corresponding to serum potassium levels could help paramedics in diagnosis. Nebulised salbutamol is recommended as the first-line management of hyperkalaemia in several healthcare areas but there are no protocols that enable UK paramedics to provide this, even though emergency vehicles carry the drug and paramedics administer it for other conditions. Establishing such protocols would allow paramedics to treat patients effectively at the scene and en route to hospital.

Recognition and management of COVID-19 and other influenza-like illnesses: a guide for paramedics

During the pandemic last year, the incidence of influenza-like illnesses (ILIs) was significantly lower, as preventive measures aimed to reduce the spread of COVID-19, were also successful in preventing the spread of other respiratory illnesses. With relaxed COVID-19 measures and the return of social contact and mixing, a significant increase in ILIs is anticipated this winter. Common causative pathogens for ILIs include influenza viruses, parainfluenza virus, respiratory syncytial virus (RSV), rhinovirus and SARS-CoV-2. With similar characteristics and mode of transmissions, it may be difficult to distinguish between these common respiratory pathogens. Fortunately, the majority of ILIs are self-limiting and treatments for these illnesses are similar: supportive treatment to relieve symptoms while awaiting recovery. Paramedics should be aware of the warning signs of serious diseases and consider admission if they occur. Finally, good infection prevention and control measures are vital to break the chain of transmission of ILIs and protect yourselves and others from them.

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