The STREAM trial for acute myocardial infarction will compare the two gold standard emergency treatments for acute myocardial infarction: primary percutaneous coronary intervention and pre-hospital thrombolysis. Bristol paramedic Andy Halliday was responsible for enrolling the first patient on the UK mainland in this landmark study.
Chan et al state that a comprehensive medication history provides a ‘cornerstone of optimal therapeutic decision-making’ in patient care, and while it is not solely the paramedic's responsibility to achieve this, the authors suggest that taking medications to hospital with the patient could improve this process.
Trauma Care, the UK-registered charity that works to promote and define best practice in the management of trauma, held its 10th International Conference at the Park Inn in Telford this month. The first day of the week-long meeting saw paramedics and paramedic students arrive from all over the UK for a programme of talks on paramedic practice. Before the talks began, paramedics chatted over coffee with medical delegates who were attending a concurrent programme on torso trauma, and despite the early start for many, the mood was buoyant and all were eager to hear the first talk.
As you will know, paramedics need to renew their registration with the Health Professions Council (HPC) every 2 years to retain their place on the HPC Register and continue to practise using the title ‘paramedic’. This article provides some very useful information about renewing your registration with the HPC.
In ‘Recording a standard 12-lead ECG: Filling gaps in knowledge’ (Crawford and Doherty, 2009) the authors identified an apparent decline in the quality of electrocardiograms (ECGs) recorded in the clinical setting. Several primary steps to improve electrode placement and hence patient care were highlighted. This article will address additional issues that may also contribute to the decline in ECG quality and propose ways in which practice may be further improved.
Despite the ambulance services' regular exposure to abdominal pain-related emergencies, pain management seems to be a persistent chink in their armour. Notwithstanding the advancements in pre-hospital health care, this age-old problem continues to remain uncorrected. With a greater understanding of pain and analgesia, coupled with a reminder of basic training, pain management need not be the paramedic's Achilles heel.
Clinical leadership is playing an ever-increasing role in the NHS and is a core element of NHS Modernisation. Clinical leadership within the ambulance service has traditionally been the primary responsibility of the Clinical Director, but as care delivered by the ambulance has altered over recent years, the aim being fewer patients transferred to emergency departments (EDs), and more patients being treated and clinically managed at home, the need for appropriately educated clinical leaders with experience, clinical credibility and influence at all levels in ambulance services is now vital. Historically other professions, such as medicine and nursing, have developed identifiable clinical leadership roles, supported by a range of educational programmes.
This case study involves the critical analysis and reflection of the ethics involved when an emergency care practitioner closed a 16-year-old patient's self-inflicted wounds at scene, rather than transporting to A&E.The article aims to show the challenges faced by ambulance personnel in the pre-hospital setting when faced with issues surrounding patient autonomy, consent and capacity and how these should be considered on a ‘case by case’ basis.