Resuscitation of a young woman following beta-blocker overdose

Mark Durham presents a reflective account of a case from practice

An introduction to reflective practice

This article aims to describe the process and theory of reflective practice and outline some reflective practice models for consideration for paramedic practice. Reflective practice is not just about writing an assignment, it is about looking back (reflecting) on a situation and taking another objective view of the incident. Reflective learning is a process where examination and exploration of an issue of concern, triggered by a specific experience, is clarified into some form of meaning, thus changing the individuals' perspective. Four reflective models have been presented—each with similar steps—so that readers can chose which one suits their practice. If undertaken well, it can enhance and develop new knowledge, initiate changes to practice and ultimately, improve patient care.

Spreading the message, but will it sink in?

The next stage of national moves to raise public awareness of the symptoms of stroke and the need to treat it as an emergency is scheduled for early 2009

Spotlight on Research

Using reflexive interviews to gather information, this research focuses on spouses' reports (n = 19: 13 females, 6 males) of initiating an emergency call due to their husband/wife suffering acute chest pain. The study also includes exploration of participants' perceptions of the overall prehospital emergency care experience from the viewpoint of an observer rather than as a patient.

Prehospital pharmacological interventions in acute asthma: A rationale for use

Ambulance service practitioners have an array of medicines available to alleviate the symptoms of an acute asthma attack; these include sympathomimetics (β-adrenoreceptor agonists and β-adrenoreceptor agonists), antimuscarinic agents (sometimes referred to as anticholinergic agents) and corticosteroids. In order to provide the best level of care to a patient suffering from an acute asthma attack it is essential that the attending practitioner understands the mechanism of action of the medicines he/she will administer and the adverse effects of those medicines. This article provides an overview of the mode of action of these medicines, discusses why the adverse effects occur, and questions JRCALC guidelines.

An introduction to pharmacodynamics

This article gives an overview of the principles of pharmacodynamics—the effect that drugs have on the body. A basic understanding of this aspect of pharmacology and in particular how drugs interact with the four main types of regulatory proteins (receptors, enzymes, ion channels and carrier molecules) is important in understanding their therapeutic and adverse effects.

Asthma: an overview of prehospital care

Asthma exacerbations are characterized by progressive increase in shortness of breath, decrease in expiratory airflow, productive or non-productive cough, wheezing and feeling of chest tightness. Emergency hospital admissions for asthma are costly and it is estimated 75% are avoidable through effective asthma management and routine care. This article addresses asthma management in prehospital care explaining relevant underlying pathophysiology of asthma exacerbations to provide clinicians with a greater understanding of asthma and its pharmacological and ventilatory management. .

Called to account

Just like other health care professionals, paramedics are sometimes called to account for their actions and omissions. The role of the Health Professions Council (HPC) is to call into question any allegation made about a health professional that queries their fitness to practice in the UK by reason of misconduct or lack of competence. A number of cases come before the HPC that call into question a paramedic's competence and conduct. For example, a paramedic was stuck off the register at a professional misconduct hearing that went before the Conduct and Competence Committee in November of this year. The allegations concerned an incident in which a paramedic and an emergency medical technician comprised the crew of an ambulance which had attended a patient in cardiac arrest at a petrol station. The patient had been taken to hospital but was found to be dead on arrival.

Being there for practitioners in times of need

The Ambulance Services Benevolent Fund is a charity which offers support to service members in times of genuine hardship.