Volume 10 Issue 1

Airway management and endotracheal intubation by paramedics for cardiac arrest

Paramedics are trained to perform endotracheal intubation (ETI), though a step-wise airway management approach has led to the use of supraglottic airway devices (SGAs), often in place of ETI. The current article considers airway management by paramedics during cardiopulmonary resuscitation (CPR). A case-note review relating to adult out-of-hospital cardiac arrests was carried out, with the collection of data over the period of a year, in one region of the UK. The results indicate that airway management is inconsistent during CPR, though simple adjuncts are used successfully. In a cohort of 2779 patients, in resuscitated cardiac arrest, attempts to intubate were made in less than half of the patients. Less than a third of patients were successfully intubated. Reasons for not attempting intubation need further investigation, alongside reasons for unsuccessful attempts.

Key areas of interest for paramedics in 2018

There are a number of exciting developments for ambulance services on the horizon this year. In this comment, Alistair Quaile will look ahead to the key areas of interest that will affect paramedics in 2018.

A look at discussions on JPP's social media

What are paramedics tweeting about?Paramedic Practice @Para_PracticeA shortage of #paramedics will leave #patients at risk - what would you say to anyone considering a career in paramedicine? How would you like to see the staffing situation resolved?@josephfraI don't think there is a shortage in Paramedics. There's a shortage in Paramedics willing to work for an ambulance trust. How can the trusts respond is what we should be asking.@SaviourMedicalDevise route in that doesn't exclude mature students with a life that cannot take on the debt of university, and retain staff by better shift patterns, actually having a work/life balance and a showing to staff a huge dose of respect for the job that is done.@Lill_LegsI agree with degree level but not the entrance criteria. Could it be weighted towards factors outside academia? An A grade student doesn't necessarily make an A grade paramedic.Paramedic Practice @Para_PracticeSome very moving stories - how do you feel about showing emotion in front of your patients? Is it unprofessional or a sign of humanity?@BetterParaConfSign of humanity. Which isn't to say it happens often, and one should be mindful of not crying more than those you are looking after, but the etymological root of ‘care’ is via lament and sorrow, so intertwined with empathy.@stoners01Being able to work with negative emotion and empathy are the key to compassionate and effective communication. @swasFTCCT have been delivering education for staff in this area - there are many barriers/reasons & fears why clinicians and patients block emotionGerry Egan @Gerry_EganReally proud of my team and yes its a journey but this is a big step, thank you CHM for a very fair hearing #ParaPrescribing

More than assessment skills: a necessary foundation

Let's take in the eye-catching cover of Assessment Skills for Paramedics. Immediately the target audience is made clear: paramedics. As is the topic: assessment skills. But the title is just a pretence to lure the reader in; in reality, this book offers much more.

A daily juggling act…

In this first instalment of the Journal of Paramedic Practice's Student Column, third-year student, Eleanor Chapman, explores the stresses of time-management as the pressure piles on. Balancing essays, placements, and presentations with home, friends and family is a steep learning curve.

Combat Application Tourniquet: best practice use

In this new monthly feature, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontlines, highlighting the importance of these skills and how to perform them. In this month's issue, Rory McKelvin discusses best practice use of a combat application tourniquet.

An innovation in mental health specialty placements

The current article describes how an innovative approach to mental health training for student paramedics can prepare the future workforce with the skills and knowledge needed to provide high-quality care. Action research methodology is used to describe the delivery and evaluation of the placement, identifying its key and sustainable learning impacts for all involved. Key to its success was the co-production of the placement from beginning to end, including service users and qualified paramedics. The outcome of the placement enabled students to develop the confidence and ability to provide compassionate person-centred care as well as the skills to cultivate self-care and resilience.

The Four Pillars: outlining and aligning our future

As we enter a new year, everyone is making new year's resolutions and working to become the best versions of themselves—the Journal of Paramedic Practice is no exception. In this comment, our Editorial Board Member, Georgette Eaton, together with Will Broughton from the College of Paramedics, introduce the journal's new format and sections aligned with the ‘Four Pillars of Practice’.

Cardiac arrest resources that improve patient outcomes

Survival rates for out-of-hospital cardiac arrest (OHCA) patients in the UK are low compared with other developed countries. UK ambulance services are in an important position to influence these survival rates by improving their ‘chain of survival’ (Nolan et al, 2006). A paramedic-led resource, with enhanced technical and non-technical skills specialising in OHCAs, has been shown to improve patient outcomes in this population group in the UK. The author proposes that this concept should be considered by all UK ambulance services to improve OHCA patient survival.

Continuing Professional Development: Vital airway management skills when treating a pulmonary embolism

OverviewA pulmonary embolism (PE) is an occlusion of the pulmonary artery that occurs because of a thrombus originating from a deep vein thrombosis. In this CPD module, we will highlight key steps in performing respiratory assessment of a patient with PE, and outline paramedic treatment and management of this condition. A PE results in ventilation with a reduced perfusion. Early intervention to maintain the airway and facilitate oxygen delivery can reduce PE-associated mortality.

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