OverviewPain is the most common presenting symptom in patients in the emergency setting, and, as such, the management of pain has been described as potentially one of the most important outcome measures for many prehospital conditions. However, paediatric pain management is a complicated issue, and various barriers exist which prevent paediatric patients receiving optimal prehospital analgesia. These could be described as barriers attributable to the provider, the system, and the patient. This module will investigate each of the three hurdles which act to prevent optimal prehospital paediatric pain management by examining current scholarly evidence, and conclude by suggesting solutions to begin overcoming the challenge of managing children in pain in the prehospital setting.Learning OutcomesAfter completing this module you will be able to:▪ Understand the concept of the ‘hierarchy of evidence’, and describe its importance in healthcare research.▪ Outline how to undertake a literature search▪ Describe the three main barriers in the adequate provision of analgesia to children in the prehospital arena.▪ Understand the implications of poor pain management in children.▪ Identify the analgesics currently recommended for paramedic use in the management of pain.▪ Reflect on the ways in which you could alter your practice to achieve better prehospital pain management for the children you treat.
The need for appropriately trained clinical leaders with experience and influence at all levels in the ambulance service is paramount. Here, Lynda Sibson, Alison Walker and Anthony Marsh discuss the establishment of a National Steering Group on Clinical Leadership and the launch of a strategic framework document.
The concept of Locus of Control (LOC) has been written about extensively since the term was first introduced by Rotter in 1966. Locus of control and a person's position along a bipolar scale of internalism to externalism has been shown to have effect on many aspects of one's life. Position on the scale varies according to the aspect of an individual's personality that is being examined, for example occupational, educational, health etc. This article will examine the benefit of an internal locus of control (iLOC) for an individual (a supervisee) in relation to clinical supervision and continuing professional development.
Anaphylaxis is a severe and life-threatening hypersensitivity reaction. As it is a common presentation, it is vital that ambulance clinicians can recognize the signs and symptoms of this serious condition to enable the prompt and safe administration of life-saving treatment. This article presents an overview of the normal immune response and aims to provide clinicians with an increased understanding of the pathophysiology of anaphylaxis and its signs and symptoms. The pharmacology and the evidence base behind the interventions currently recommended to treat this condition are also discussed and some suggestions are made for future paramedic practice.