Volume 12 Issue 12

Miscarriage, SUDI and neonatal death: paramedic experience and practice

This article aims to provide an exploratory investigation into paramedic experiences of attending cases of miscarriage, sudden and unexpected death in infancy (SUDI) and other forms of neonatal loss. It draws on a background literature review, but focuses primarily on exploring issues raised by paramedics during a structured discussion group on this topic. Existing literature highlights the ways in which baby and infant death is one of the most stressful and challenging areas of paramedic practice. Paramedics participating in our discussion group reinforced this issue, identifying five key areas of concern: baby loss as a rare occurrence, resuscitation, lack of information concerning the post-admissions process, professional closure, and support to parents. Further research is needed, along with better support and guidelines to assist paramedics with a wide range of issues from resuscitation to bereavement.

ParaVR: a virtual reality training simulator for paramedic skills maintenance

Background: Virtual reality (VR) technology is emerging as a powerful tool in medical training and has potential benefits for paramedic education. Aim: The aim of this paper is to report the development of ParaVR, which uses VR to maintain paramedics' skills. Methods: Computer scientists at the University of Chester and the Welsh Ambulance Services NHS Trust (WAST) developed ParaVR in four stages: identifying requirements and specifications; alpha version development; beta version development; and management—development of software, further funding and commercialisation. Results: Needle cricothyrotomy and needle thoracostomy emerged as candidates for the prototype ParaVR. The Oculus Rift head-mounted display was combined with Novint Falcon haptic device and a virtual environment crafted using 3D modelling software, which was ported to the Oculus Go virtual reality headset and the Google Cardboard VR platform. Conclusion: VR is an emerging educational tool with the potential to enhance paramedic skills development and maintenance. The ParaVR programme is the first step in the authors' development, testing and scaling up of this technology.

Paramedic use of IV amiodarone to terminate supraventricular tachycardia

The introduction of specialist services within the hospital network has increased conveyance times for many patients, as paramedics look to deliver them to the most appropriate hospital first time. Patients with potentially life-threatening arrhythmias can decompensate quickly, increasing the need for pharmacological management of these conditions en route. Amiodarone is carried as part of the existing paramedic formulary and is used to terminate paroxysmal supraventricular tachycardia (PSVT), resistant to cardioversion, in the hospital. With appropriate training and education, paramedics could safely deliver amiodarone to this sub-group of cardiac patients, while en route to hospital for definitive treatment.

PTSD in paramedics: history, conceptual issues and psychometric measures

Post-traumatic stress disorder (PTSD) is more common in paramedics than in the general population because of the stressful and distressing nature of their work. Forms of PTSD associated with chronic stress and repeated trauma are scarcely researched among paramedics. This is striking as this workforce is potentially more likely to be affected by these types of PTSD. Diagnostic processes are still largely based on acute rather than chronic psychological trauma. PTSD diagnosis has been influenced by sociological perceptions of mental illness and changes in diagnostic criteria. Criteria for the diagnosis of PTSD in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases have changed in the past decade, which may facilitate more appropriate diagnoses of PTSD in paramedics. Paramedics often have a complex aetiology of PTSD resulting from experiences of both chronic and acute events. Questionnaires that cover exposure to both individual and repeated stressful events are required to enable further research in the area of PTSD in paramedics.

Looking back and ahead

After having begun this column as a first year student paramedic, Ellie Daubney, now a Temporary NQP, writes her final column as she reflects on her past—and her future

College of Paramedics student council elections

As the College of Paramedics launches a new student council to ensure student involvement across all regions of Britain, candidates, Rhys Sycamore and Simon Thompson, share some of the issues they feel most need addressing in their respective regions

The short war of a Quaker Ambulance Unit

James ‘Bill’ Chadkirk is retired and is a historian of Quaker involvement in Russia. He is currently researching a comprehensive study of the topic and works closely with a Quaker charity in Russia.

Paramedic ethics, capacity and the treatment of vulnerable patients

Vulnerable patients are at an increased risk of harm or exploitation in healthcare. Their vulnerability may impede their autonomy, which can then affect their ability to self-advocate. Clinicians have an important role in supporting vulnerable patients and upholding their autonomy. This article explores practical issues of capacity, autonomy and beneficence as they apply to some of the most common vulnerable groups that UK paramedics may encounter: children, older people, those with a mental illness and persons with a disability.

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