The only practical CPD journal for paramedics

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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

Managing ambiguity and uncertainty in clinical decision-making

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.

Effects of nebulised beta-2 agonists on clinical observations in asthma exacerbations

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: aetiology, identification, management and the future

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.

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