The revised Resuscitation Council (UK) Guidelines have recently been published and include, for the first time, a chapter on prehospital cardiac arrest that aims to ‘bring together those resuscitation topics of specific relevance to the prehospital emergency medical emergency services’ (Resuscitation Council, 2010: 36).
In July 2010, the Department of Health published a document titled: ‘Building the evidence base in prehospital urgent and emergency care: a review of research evidence and priorities for future research’. This document reviews the existing research and evidence in the field of prehospital urgent and emergency care, and identifies gaps where future research would be valuable. Here, Samantha Brace, Research Fellow, Clinical Trials Unit, Warwick Medical School and Advanced Clinical Practitioner, Emergency Medicine, Heart of England NHS Foundation Trust, and Matthew Cooke, Professor of Emergency Medicine, Warwick Medical School and Heart of England NHS Foundation Trust, comment on the report in depth. Email for correspondence: m.w.cooke@warwick.ac.uk
This research examines the feasibility of emergency physicians using portable cardiotocometry in the prehospital setting within an emergency medical services (EMS) unit linked to a French teaching hospital.
This book provides another dimension to paramedic practice and those involved in health care delivery in general.
Mark Glencorse, NHS Operational Paramedic Team Leader, Author of 999medic.com, and Co-Host and European Programme Director of ‘The Chronicles of EMS’, updates JPP on the main issues that emergency medical services (EMS) blogs are focusing on and the topics that are creating the best discussions this month. Email for correspondence: mglencorse@yahoo.co.uk
The paramedic profession has undergone a period of transition in the past decade. One of the most fundamental changes is the emergence of higher education (HE) as central to the development of qualified paramedics and those looking to enter the profession for the first time. Amidst a back-drop of regulation and increasing expectations, the position of HE has become one of the key drivers for a profession facing increasing challenges. This article explores the theoretical concepts which underpin the delivery of paramedic training within the HE setting. A number of different teaching strategies are examined which demonstrate how HE equips paramedic students with the skills needed to operate effectively in the prehospital setting. The concept of an autonomous practitioner is discussed and specifically, the role which HE has to play in their development. Consideration is also given to the way in which HE can empower paramedics to continue their development post qualification.
This small scale study explores the relationship between universities curricula, to that of the student experience within their clinical placement. Students attending a UK university which has been delivering paramedic programmes for a number of years took part in the study. A sample of 60 paramedic students were randomly selected and asked to participate. Ethical approval was gained and relevant information and advice disseminated to the participants. A grounded theory approach was used—incorporating a structured questionnaire, allowing for quantifiable data to be retrieved and analysed. In addition, qualitative data was gathered, via the use of ‘free text’ to enrich the study, by allowing participants to expand on their feelings and experiences. Descriptive statistical analysis of the quantitative data revealed that many students felt their clinical competencies and personal confidence were sufficient within the clinical setting. In addition, through qualitative thematic analysis, a number of areas were identified which reflects the student experience of university curricula in relation to clinical practice.
Rapid sequence intubation (RSI) is the cornerstone of emergency airway management. It is a safe procedure when used by adequately trained personnel, even in the prehospital setting. Measurements of the partial pressure of exhaled carbon dioxide (PetCO2) via capnometry/capnography have several useful clinical applications and are extensively used by prehospital providers to monitor critically ill and injured patients. This article reviews the role of monitoring PetCO2 values during RSI.
An increasing number of patients with long-term tracheostomies or laryngectomies are being managed in the community. However, recent evidence suggests that many clinicians from both the hospital and prehospital setting lack sufficient skills and knowledge to safely manage them in emergency situations. This article describes the anatomical and pathophysiological variations that may be encountered in tracheostomy and laryngectomy patients, and relates them to the adaptations that may be required when managing this group of patients in the prehospital setting.
In August 2010, JPP published an article by Mark Hodkinson, titled ‘The future of paramedic intubation: who should be responsible?’. JPP has received a letter regarding this, which is printed below.
Since 2007, Teesside University has been successfully running a foundation degree in paramedic science for pre-registration student paramedics. The programme is run in conjunction with both the North East Ambulance Service and Yorkshire Ambulance Service NHS Trusts and is now well established with over two hundred students graduating since its conception.