Postgraduate opportunities in research at NEAS

The North East Ambulance Service NHS Trust (NEAS) is offering a unique opportunity to qualified and enthusiastic paramedics who wish to understand the research process and assist with the delivery of high quality clinical research. Recently, joint funding has been secured to support four dedicated paramedics to undertake a master of clinical research at Newcastle University. These academic posts are a joint initiative between the research and development (R&D) department and the clinical education and development department at the trust. Together, we anticipate that this successful collaboration will strengthen working relationships and maximize our common objectives in the future. This article highlights these novel scholarships which are currently available in the North East region.

Update on inducing hypothermia

In April 2010, JPP published an article, titled ‘Prehospital induction techniques: mild hypothermia during advanced life support’. Written by Stefano et al, this article explored the different techniques used to induce hypothermia during prehospital cardiovascular arrest. JPP has received a letter regarding this, which is printed below, along with a response from one of the authors.

Spotlight on Research

Tracheal intubation with a cuffed tube is considered the definitive method of airway management in adults, but if the cuff pressure is above 30 cm of water, then the blood flow to the tracheal mucosa can become restricted—causing complications such as ulceration and ischaemia.

Book Review

This book is a departure from a number of paramedic texts in that the emphasis is not on anatomy, physiology and the physical sciences, but rather the social sciences.

Becoming a reflective practitioner: frameworks for the prehospital professional

The concept of reflective practice within healthcare is not new. Reflection is a process which enhances learning and knowledge acquisition and is popular among health professionals. It appears that paramedics, emergency clinicians and student paramedics are using reflective practice as the learning tool of choice. Reflective practice is undertaken for a variety of reasons including self-development, and as a means of demonstrating accountability to the Health Professions Council (HPC). The HPC recognize reflective practice as one option that will contribute towards satisfying continuous professional development requirements for the paramedic. This article discusses origins of reflection and critical inquiry, drawing upon the work of influential characters who have allowed the reflective paradigm to become what it is today. It further discusses reflective practice, critiquing three popular models and in addition, identifies alternative models of reflection specifically designed to be used by those who work within the prehospital care setting.

Mentorship for paramedic practice: are we there yet?

Mentorship is a key element of professional life, underpinning student development and supporting qualified staff as they advance their own clinical and professional practice. Mentorship has its origins in industry in the US and was adopted, largely unchallenged, into nursing practice in the UK in the 1980s. Although there is a wealth of evidence surrounding mentorship in nursing, very little published literature exists for mentorship in paramedic practice. The first of four articles, this paper will outline some of the definitions of mentoring and concepts related to mentorship, such as the attributes and qualities of an effective mentor.

To move or not to move: are the general public confused about moving patients?

The management of trauma patients who have possible spinal cord injury with immobilization is standard professional practice. However, very little is known about how the general public, who are often first to arrive at the scene of an accident, manage such patients. A primary cross-sectional survey was conducted which asked members of the public how they would manage a fictional patient who had been knocked off his bicycle in a road traffic accident. The survey found that for some members of the public (8%), their overriding priority was that the patient must not be moved under any circumstances. Their fear of causing or exacerbating spinal injury was so great that they would not move the patient—even in order to undertake life-saving procedures such as cardiopulmonary resuscitation. The survey found that although only a small number of patients risk being affected by misinformed or confused members of the public, the consequences for such patients could be fatal. Given the seriousness of the consequences, there is a case for a public information campaign to remind the public of the correct prioritization of immediately life-saving interventions over spinal cord protection.

Prehospital treatment of hyperkalaemia

This article explores the assessment and management considerations of patients with hyperkalaemia. Using a case study from clinical practice, the hospital treatment is reviewed with particular emphasis upon the use of calcium, insulin and dextrose. In particular, potential prehospital treatments are considered, with focus upon the use of salbutamol and furosemide. Definitions, incidence and mortality rates of hyperkalaemia are also detailed. The signs, symptoms and causes of the condition are examined, with the aim of achieving prehospital diagnosis in the absence of serum potassium levels. Hyperkalaemic electrocardiogram (ECG) changes are studied and examples are given. Conclusions are made, including a recommendation for the prehospital use of salbutamol in the treatment of hyperkalaemia.

Care Quality Commission: regulating ambulance services

The Patients' Forum is a voluntary sector organization that has been monitoring the London Ambulance Services (LAS) since 2003. The Forum was originally a statutory sector body and has continued actively monitoring LAS services and collaborating with staff to improve services. Here, Malcolm Alexander, Chair of the Patients' Forum Ambulance Services (London) and National Association of LINks Members, reflects on current developments with the regulation of ambulance services and uses material from a public meeting with senior Care Quality Commission (CQC) staff who are leading on the regulation of ambulance services.

Informed consent

While delivering care to patients, are we always sure that patients are consenting to treatment? Informed consent is a legal term that is used to indicate that a patient has provided consent that meets agreed minimal standards. Informed consent can be seen to be given if it is based upon a clear understanding and appreciation of the facts, implications and further consequence of action.

Prehospital care: a patient's story

This article provides a real life patient account of one woman's experience of prehospital care following being injured in a serious road traffic collision in August 2006. The article will focus largely on the prehospital phase of her experience, but also draw upon the patient's wider experience of treatment following the collision.