Paramedic independent prescribing is in its infancy and there are limitations to the range of medicines that can be prescribed when compared with other professions undertaking independent prescribing. Medication and prescribing errors are common events within the NHS in England, resulting in a substantial number of litigation and fitness-to-practise proceedings against other professions in relation to prescribing and medicines management. It is foreseeable that paramedic independent prescribers could also find themselves subject to legal action. This article considers a fictitious scenario where a patient suffers harm as a result of a prescribing decision and the legal implications for the prescriber.
Paramedics often come across death because of the nature of their work. Attending an incident involving the death of a patient could affect a paramedic's mental health. A scoping literature review surrounding the readiness and education regarding death in the prehospital setting for paramedic students was carried out. Given the potential impact upon practitioner mental health, the review aimed to determine the quality and extent of new research regarding education in death for paramedics. Four themes arose from the review: inadequate preparation; methods of death education; improved confidence; and implications for more research.
The reliability of the electrocardiogram (ECG) after return of spontaneous circulation (ROSC) is unclear. While its predictive value has previously been described, no studies have looked at the influence of time on the post-ROSC ECG.
This study aimed to evaluate the predictive value of the ECG immediately after ROSC and between 1 and 5 hours later to assess whether time influences its ability to accurately predict the need for percutaneous coronary intervention.
A single-centre, retrospective, observational 1-year analysis examined the records of post-ROSC patients who underwent coronary angiography and for whom prehospital and delayed post-ROSC ECGs were available for analysis.
Forty-two post-ROSC ECGs were reviewed alongside angiographic findings. Sensitivities of 25% and 69%, specificities of 60% and 100% and an accuracies of 33% and 76% were calculated for the prehospital and delayed hospital ECGs respectively. A chi-squared value of 7.78 (P=0.0053) suggests there is statistical significance between the two.
The delayed post-ROSC ECG is statistically significantly more accurate, suggesting that time influences the reliability of the post-ROSC ECG.
In this month's instalment of Paramedic Roles, Angela Moore provides an insight into the role of a forensic paramedic, with a brief run-down of her daily responsibilities, as well as a reflection on her overall motivation