Chest auscultation is a simple but informative procedure which can make an effective contribution to clinical decision-making provided the sounds are interpreted accurately. Williams et al recruited 96 undergraduate paramedic students from two Australian universities and exposed them to six lung sounds of varying aetiology. Each cycle of sounds comprised five breaths followed by a pause before the next sound commenced.
The modern paramedic will now undertake their professional training within a UK higher education institution (HEI). In addition to their specialist clinical training, other critical elements such as research methods will feature as an integral part of their programme. Often this component of the programme is not delivered by academic paramedical staff, but by personnel with other professional backgrounds. In this paper we acknowledge that the base of paramedic practice is still developing in HEIs and the development of the academic paramedic is ongoing.Students often face many challenges when undertaking the research methods module within their programme and to best facilitate this, we advocate that this part of the programme is delivered by academics with a background as a paramedic to give the best contextual learning experience.
This case study covers an incident when the decision of whether to recognize life extinct (ROLE) at an out-of-hospital asystolic cardiac arrest resuscitation attempt after 5 minutes or to complete the full 20 minutes of resuscitation as recommended by the Joint Royal Colleges Ambulance Liaison Committee guidelines, when the cause of cardiac arrest was undetermined, was required. It was also necessary to weigh up the benefits of when to, or indeed if to, transport the asystolic patient by helicopter to the district general hospital.This incident provided evidence of what could have been a cardiac arrest prior to trauma but also trauma followed by cardiac arrest. Questions posed by this incident included whether the introduction of a 1-month trial period of a doctor on the helicopter assisted the crews in the decision-making process or changed the dynamics of the group and the normal decision-making process.
Substance misuse is becoming increasingly common and is a problem that is likely to be encountered by every prehospital clinician at some time. Substance misusers are frequently demanding and aggressive but the highest standards of management and protection for both patient and clinician must be given. Becoming more informed about the many potentials of patients with substance misuse is therefore an important issue for paramedics. It is useful to be able to actively source knowledge at times of crisis with a greater understanding of what inter-agency services are available in your area (including out of hours) to improve the management of these patients. This article gives a brief overview of some of the substances of misuse, some commons street names and details how education and research is not only a part of meeting standards for registration but provides a key element in the management of substance misuse.
Normal birth is a common outcome for the ambulance service following an imminent birth dispatch. In 2008, the London Ambulance Service attended over 1000 imminent births calls, with the crew either in attendance for a birth, transporting prior to birth or the infant born before arrival of a crew. The majority were full-term, low risk pregnancies with a normal birth, and the mother having birthed previously (personal communication, London Ambulance Service, 2009).The aim of this paper is to review the issues of normal birth. It will explore the concept of normal birth and encourage practitioners to reflect on care after a normal birth. It discusses the physiology and mechanism of normal labour, birth and physiological placental expulsion. The paper will explore the ambulance clinician's role in securing and maintaining a normal birth outcome and explore care required for the woman, newborn infant and family. This paper will not discuss complications in pregnancy and during labour or in depth discuss birth, postnatal complications or newborn resuscitation. Ambulance personnel must follow the guidelines issued by the Joint Royal Colleges Ambulance Liaison Committee UK Ambulance Service Clinical Practice Guidelines (2006) (JRCALC, 2006).
The Health Professions Council (HPC) has recently closed the period of consultation that will help them develop guidance for conduct and ethics for students. The consultation involved students, practising paramedics, and academic staff, and the guidance aims to provide students on education and training programmes with direction on issues of conduct and ethics. It is the role and function of the HPC to set standards of conduct, performance and ethics which apply to paramedics. The guidance that will eventually be produced cannot, and will not, provide answers to every situation concerning conduct, performance and ethics; it can only give broad principles that aim to offer assistance and direction. Education and placement providers also have their own policies and procedures that must be followed.