Paramedics are regularly exposed to traumatic situations in the prehospital environment, which can profoundly affect their emotional resilience. A debrief is a recognised tool that is used to manage the aftermath of such events. Its aims are to unpick the components of the situation, identify any issues or achievements in clinical care, highlight learning points to improve future practice and safeguard the clinician’s emotional wellbeing. This article explores the benefits of and barriers to debriefing in clinical practice as well as the emerging debate around the potential harm or benefit of single-session debriefing.
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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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Paramedics are legally and professionally obliged to uphold their patients' right to dignity, respect and autonomy—and this includes the general requirement to obtain their consent before proceeding with any intervention. The first instalment of this two-part article considered the challenges that this might present to the paramedic. This second article develops this theme and further explores the legal framework underpinning the decision-making process when caring for a patient approaching the end of life. It also examines issues around consent and mental capacity in more depth and addresses matters such as such as advance decisions to refuse treatment (ADRT) and do not attempt cardio-pulmonary resuscitation (DNACPR) decisions.
Vulnerable patients are at an increased risk of harm or exploitation in healthcare. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. This article explores practical issues of capacity, autonomy and beneficence as they apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, those with a mental illness and persons with a disability.
Caring for patients who are approaching the end of life is an important part of the paramedic's role. Patients' circumstances are individual; for some, death is expected and may even a welcome (albeit sad) relief from a long period of pain and distress, while for others it is a tragic, unexpected outcome after every effort to prevent it has been exhausted. Regardless of circumstances, paramedics have to make wide-ranging clinical decisions, underpinned by a complex legal and regulatory framework. Paramedics generally have to obtain a patient's informed consent before proceeding with any intervention. They may be challenged if a dying patient refuses life-sustaining treatment or no longer has the mental capacity to consent and need to know the law on decision-making in these cases. This article discusses issues around capacity and consent at the end of life. The next article in this series considers issues such as advance decisions to refuse treatment and do not attempt CPR decisions.
In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills...
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- Saturday, January 2, 2021
Background: Prehospital emergency medical services (EMS) are believed to be responsible for the...
- Sunday, August 2, 2020
Aims: This study aimed to evaluate the ‘think aloud’ teaching exercise's ability to develop...
- Monday, December 2, 2019
Background: Frontline paramedics are increasingly attending to non-emergency problems and calls...
Leadership and management
- Wednesday, December 2, 2020
Background: Virtual reality (VR) technology is emerging as a powerful tool in medical training and...
- Wednesday, December 2, 2020
Post-traumatic stress disorder (PTSD) is more common in paramedics than in the general population...