Volume 1 Issue 15

NWAS Library and Information Service

Matt Holland is Outreach Librarian in the North West Ambulance Service. Here he explains his unique role, and the steps involved in the development of a Library Information Service.

National research guidance and support for Trusts

The Research Design Service (RDS) is one of the key components of the National Institute for Health Research (NIHR) which aims to position, manage and maintain world-class research in the National Health Service (NHS). Formed in 2008 as a component of the Department of Health's Research and Development (R&D) Strategy, Best Research for Best Health (Department of Health, 2006), the NIHR RDS is a major new initiative in which the NIHR will be investing around £50 million over 5 years. This article provides an overview of the RDS and highlights some of the major developments and consequential opportunities for Ambulance Trusts in England.

The future of air ambulance services in trauma care

This article explores the development of air ambulances from being vehicles for inter-hospital transfers to being the modern frontline resources for prehospital care. The service models currently utilised by the various air ambulance charities are explored, as is the influence each of these may have on the delivery of patient care. The organizational structure of air ambulance charities is addressed, as it also impacts upon service delivery and the governance of clinical practice. This area gives rise to an exploration of the potential for air ambulances to offer a unique platform for the development of the paramedic profession and an expanded scope of clinical practice. The article also explores the effect of wider changes within health care and how this impacts upon the services provided by air ambulances. Analysis of potential future developments based upon a number of factors is made and conclusions drawn with regard to both current and future practice development.

Patient assessment: a reflective case study

The three ‘C's of physical assessment—capacity, consent and communication—could be compared to the ‘ABCs' of resuscitation; without all three you will make very little, if any, progress. But do we give these aspects the attention they deserve, especially in time critical situations? This case study is based on a 76-year-old female who presented at Accident and Emergency (A&E) with central chest pain, diarrhoea and vomiting, productive cough and pyrexia. The aims of this case study are to discuss the impact of 21st century legislation on patient assessment, demonstrate the importance of objective, structured history taken and investigate the subjective nature of physical examination. In a world of waiting lists and litigation some argue that we should let technology do the leg work—ultrasound, chest x-rays, magnetic resonance imaging (MRI) and computed tomography (CT)—why use a stethoscope?

COPD: an overview of prehospital care

Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. It is a debilitating airways disease which presents to the ambulance service with varying severity and is characterized by airflow obstruction which is usually progressive, not fully reversible and does not change markedly over several months. It may coexist with other comorbidities such as cardiovascular disease, making diagnosis of exacerbations difficult. COPD management in the prehospital environment is focused on effective recognition and the early application of pharmacological intervention to alleviate symptoms using current Joint Royal Colleges Ambulance Liaison Committee Guidelines.

Supporting staff wellbeing

Most ambulance trusts would espouse the fact that they are committed to the health and welfare of their employees believing that their health and wellbeing are essential for their efficiency and effectiveness.

Is it curtains for Nellie?

People frequently suggest singing Nellie the Elephant (Nellie) to help maintain good compression rates during cardiopulmonary resuscitation (CPR), but is this practice evidence-based? This prospective randomized crossover trial included 130 people who had little or no previous experience of CPR. Having given participants a brief training in chest compression they were asked to perform three sequences, pre-randomized for order, of 1-minute per sequence of continuous chest compressions on a skill meter resuscitation manikin accompanied by: repeated choruses of Nellie (105 beats per minute); repeated choruses of That's the Way (I like it) (109 beats per minute); and to no music at all.

Continuing Professional Development: Survivability of PreHospital Cardiac Arrest: A Survey

OverviewPrehospital cardiac arrest patients are historically known to have low survival rates. It is also a common medical presentation that ambulance clinicians have to treat. This survey looks at survivability figures of these patients brought into one hospital over a 12-month period, and discusses factors such as return of spontaneous circulation (ROSC), advanced life support (ALS) and basic life support (BLS). It also discusses the difficult choice of whether to ‘stay on scene’ or ‘load and go’.Learning OutcomesAfter completing this module you will be able to:• Appreciate the appropriate use of data and how it is affected by the Data Protection Act.• Appreciate that effective basic life support (BLS) is the most important factor in achieving a successful outcome from prehospital cardiac arrest.• Understand the importance of interprofessional and interdepartmental collaboration in allowing research and data compilation.• Understand that each prehospital cardiac arrest case is unique, and accept that each clinician must make their decision in a dynamic environment.• Reflect on future cardiac arrest patients, and be more open to the two options of ‘load and go’ or ‘stay on scene’.

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