As paramedic roles continue to grow and diversity, the number of paramedics working in primary care is on the rise. Knowledge of non-medical prescribing specifically for paramedics in these settings is necessary, as are new frameworks for medicines management beyond the ambulance services and for general practice in particuar. This instalment in the Prescribing Paramedic series discusses prescribing in primary care settings including some of the more practical aspects of relevance to paramedics.
Acute thyrotoxicosis (thyroid storm) caused by hyperthyroidism is a rare but severe endocrine imbalance which, in extreme cases, may lead to ventricular fibrillation and ultimately, without intervention, death. The authors attended such an incident and, following clinical interventions, achieved return of spontaneous circulation with a good outcome for the patient and subsequent hospital discharge.
Despite assurance measures being developed alongside expanding scopes of practice, poor NHS ambulance staff wellbeing means high-quality job performance and patient care are not guaranteed. The UK's service is struggling to cope with growing demand and is not fully adapting from its historical emergency response role to meet modern-day urgent care needs. This puts unnecessary pressures and risks of stress from exhausting, intense work on to its most valuable resource: staff. Detrimental workplace cultures exacerbate this, along with added target-driven strain from non-evidence-based ambulance quality indicators. With poor support, communication, leadership and mental wellbeing provision, staff are increasingly dissatisfied, demoralised and experiencing a myriad of health problems. Consequences include excessive staff sickness absences and turnover as well as an up to 75% higher suicide risk. Trusts should collaborate to identify and address the causes of demand that cannot be met, and chief executives and boards should work with staff to prioritise structured wellbeing assessment and improvement. Further research is also needed.
After being acutely aware of her difference as a student, Mahdiyah Bandali begins to find her footing as a newly qualified paramedic, as she grows accustomed to ‘being the change’
As he quickly nears his third year, Samuel Parry shares his excitement about now being able to confidently link together his studies from first year, with current modules and placements, and taking all of this into his future as a qualified paramedic.
In the fourth instalment of Paramedic Roles, Jared Bishop reflects on his journey in Canadian paramedicine that brought him to his current role as an advanced care paramedic (flight) in Northern Saskatchewan