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.
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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.
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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.
Publishing an academic paper and going through the submission process can be unfamiliar and daunting. This article will provide a basic overview of where to start, how to search and scrutinise journals to find the right one for your work, checking guidelines and the finer things such as whether or not to pay for your publication, getting everything ready, what to expect during the process of submission, how your manuscript is reviewed and how a decision is made. Familiarising yourself with the basics of the submission process will make it less intimidating as you will know what to expect and how to prepare.
Of people aged 65 and older, 30% will fall at least once per year—for people aged over 80, this rises to 50%. Patients who remain on the floor for a long time are at risk of developing rhabdomyolysis. If a person cannot move or get off the floor, tissue necrosis can occur at the point of contact and skeletal muscle is destroyed, releasing its contents into the bloodstream. This can eventually lead to crush syndrome, which includes rhabdomyolysis, hyperkalemia, dysrhythmias and acute kidney injury, and can be fatal. There are no guidelines for a time period when rhabdomyolysis is more likely to occur nor international consensus on how to best treat this condition in and out of hospital. This article looks at rhabdomyolysis resulting from falls in elderly people, and how to recognise and manage it. The aim is to improve awareness of rhabdomyolysis among prehospital practitioners so they can improve its management and advise patients at home.
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