Allied health professional confidence in giving prehospital fascia iliaca blocks

Background: Fascia iliaca blocks (FIBs) are an efficacious form of prehospital regional anaesthesia for patients with neck of femur fracture. Current prehospital use is limited. Aims: The primary aim of this study was to assess procedural confidence among allied health professionals. The secondary aim was to examine concerns related to prehospital use of FIB. Methods: This was a qualitative study that analysed semi-structured interviews. Two recognised groups were involved: paramedics and advanced practitioners. Results: A total of 12 semi-structured interviews were conducted. Four factors were found to contribute to procedural confidence. All practitioners felt confident to perform the FIB. In its secondary aim, to identify concerns related to FIBs, the study found three major themes: risk of doing harm; receiving adequate training; and procedural governance. Conclusions: Procedural confidence was high. Training and governance were highlighted as barriers to procedural expansion. Research is required to assess feasibility.

Effects of simulation training on student confidence in de-escalation skills

Background: There is increasing demand for access to mental health support services both for ongoing care and at time of crisis. Preparation of undergraduate students for encounters with those with ongoing mental health care and/or at a time of psychological distress/crisis remains sporadic and difficult to encompass. Simulation gives students opportunities to develop technical and non-technical skills through the recreation of an experience that is as close to reality as possible. Method: An exploratory evaluation of teaching practice of student self-perceptions of self-awareness and self-regulation in encountering clinical situations with persons in high states of arousal and potential conflict was conducted. To evaluate the exercise and its value, students were asked to self-evaluate their confidence and knowledge both prior to and subsequent to the teaching exercise. Results: There was a positive shift in self-awareness and self-regulation post training. Confidence in being able to de-escalate a situation was reported as the key outcome to take from the session, along with techniques on how to de-escalate a scenario. Conclusion: While it is not possible at this stage to definitively measure the impact of the teaching on practice or draw firm conclusions for education providers, the evaluation exercise does evidence individual impact and enjoyment. The teaching approach may prepare the future workforce with the skills and knowledge needed to provide high-quality care.

The biology of grief

Beyond hype to reality

In her first bimonthly column, Nagina Zaroof reflects on her expectactations as a student versus the reality of practising as a newly qualified paramedic (NQP)

Spotlight on Research

Strike action

Paramedic practice in low light conditions: a scoping review

Background: Paramedics undertake visually demanding tasks, which may be adversely affected by low lighting conditions. Aims: The study aimed to: identify difficulties paramedics experience carrying out tasks in low light; and establish occupational health standards and adjustments that may improve working practices. Methods: A scoping review was undertaken informed by a professional panel of paramedics recruited through social media. A meta-analysis was conducted assessing visual acuity under different light levels. Findings: Difficulty in driving and in assessing/treating patients under low light conditions were reported. Sixty relevant studies were identified for review. Visual acuity reduces with decreasing luminance, causing increasing difficulties in performing critical tasks. Conclusion: Visual function testing can assess paramedics' visual health and ability to undertake critical tasks. Adjustments may help to improve conditions. Regular occupational health assessments could identify paramedics who need support. Further research should explore levels of visual function and practical adjustments needed for safe clinical practice.