Volume 1 Issue 2

How to carry out a search of a bibliographic database

This article, aimed at the novice, proposes a four-step approach to planning, undertaking and documenting the search for relevant literature, a vital part of any literature review. The main focus is on searching electronic databases to find research papers, but the principles described may also be applied to paper-based sources and the Internet (useful resources for research are considered).Examples are given to illustrate the process of searching using index terms, grouping concepts and applying limits.

An introduction to CPD for paramedic practice

This article outlines the concept of continuing professional development (CPD) and its application to the paramedic. CPD has long been an aspect of other health care professions, but is relatively new to the paramedic profession. The Health Professions Council (HPC) standards mean that paramedics will have to provide evidence of CPD from August 2009. The standards apply not only to those in clinical practice, but also to those working in research, management or education.CPD can initially appear daunting. However, it can, and should be, an enjoyable aspect of developing yourself and your professional practice. This article therefore aims to suggest some CPD activities for paramedic practice, with reference to some of the HPC guidelines and learning from other health care professionals.

Spotlight on Research

Early cooling of resuscitated patients improves neurological outcome, yet out-of-hospital initiation of cooling is uncommon for mainly practical reasons. This pilot study hypothesized that the use of burn cooling dressings in the out-ofhospital environment could initiate brain cooling at an earlier stage and potentially be of value. Burn dressings are readily available in most ambulance services so the method is easily adaptable for ambulance crews.

Managing childhood fever in a prehospital setting

In 2007, the National Institute for Health and Clinical Excellence (NICE) produced guidelines on feverish illness in children concentrating specifically on assessment and initial management in children under 5 years. Fever has been identified as one of the most common reasons for children to be taken to their GP or the emergency department and a principal rationale for admission to children's wards. Usually fever indicates some underlying viral or bacterial infection, which is predominantly self-limiting. However, a few are serious in nature requiring urgent treatment, such as meningitis, septicaemia, urinary tract infection and pneumonia.It is imperative that prehospital health practitioners (paramedic technicians, emergency care practitioners, nurse practitioners) have an ability to think critically about the potential aetiologies displaying this clinical feature, an understanding of current evidence-based management guidelines and a commitment to standardize practice. The aim of this article is to explore and incorporate the NICE guidelines into an appraisal of the ill child presenting with a fever, using the SOAP (subjective, objective, assessment, plan) model of assessment (Weed, 1969) for structure. Furthermore, the physiology of fever will be outlined briefly to provide baseline underpinning knowledge and understanding.

The theory and application of pulse oximetry

Pulse oximetry is widely used in the prehospital environment, yet researchers question whether health professionals fully understand the theory to support the practical application of its use.This article explores the fundamental theory of pulse oximetry to give applied understanding. From a prehospital perspective, it details and examines the advantages and limitations of this observational aid, which must be considered when making clinical decisions regarding a patient's care.

Keeping abreast of the changes

We have had a very positive response to the first edition and hope this will continue. Do remember that this is your journal—we are keen to have your feedback, comments and views on the content, and of course your contributions. We are keen to look at how policies will affect clinical practice. One such example is the report of the National Infarct Angioplasty Project (NIAP) (Department of Health (DH), 2008) feasibility study on seven pilot sites in England. The current prehospital thrombolysis treatment for acute myocardial infarction has been superseded, in some areas, by coronary angioplasty or primary percutaneous coronary intervention (PPCI).

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