Volume 7 Issue 5

Impact of pre-hospital assessment of stroke on in-hospital care

Effective pre-hospital recognition and management of stroke is an important component of the acute stroke care pathway. The practice of placing a priority (pre-alert) call to hospitals to notify receiving staff that a stroke patient is in transit enables specialist care to be available immediately on the patient's arrival in an attempt to improve timeliness of subsequent treatment.

Paramedic prescribing: a potion for success or a bitter pill to swallow?

In a climate of unprecedented demand on healthcare services, ageing demographics, population growth through immigration, a reduction in junior doctors' working hours, and overriding political agendas, the need to develop innovative new roles and expand the scope of practice for existing practitioners, including paramedics, is paramount if the NHS is to maintain resilience in an evolving healthcare system. Recent legislative changes now permit chiropodists/podiatrists and physiotherapists to independently prescribe, further fuelling other allied health professions (AHPs), such as paramedics' and radiographers' desire to become future independent prescribers. Implementation has the potential to enhance patient/clinician experiences through improved access to medicines, and would significantly reduce the need for multi-disciplinary involvement per care episode, yielding cost-efficiency savings through reduced ambulance journeys, fewer avoidable admissions, further augmenting patient care delivery. Paramedic independent prescribing (PIP) would also elicit improved inter-professional collaboration, enhance employability and promote professional autonomy in evolving advanced practice roles. Such innovation requires legislative changes, but remains paramount if paramedics are to actively contribute towards tackling the increasing burden of unprecedented demand, limited resources, and ongoing commitment to achieve cost-efficiency savings within the modern NHS.

Independent prescribing: a journey to provide the best possible care

Many patients benefit, and will continue to benefit, as a result of paramedics being able to administer medicines under standards set by the Medicines and Healthcare products Regulatory Agency and the National Institute for Health and Care Excellence, regarding the use of patient group directions (PGDs), patient specific directions (PSDs) and exemptions. It is not uncommon, however, for these mechanisms to prove ineffective. This can result in delays for patients receiving the care that is best suited to their individual needs.This article looks at how independent prescribing by paramedics would allow patients to receive the care and medicines they need, resulting in a far greater number of patients benefiting from improved and more timely care and greater convenience.

Prioritising the development of paramedic students' interpersonal skills

Objective:This paper analyses residential-aged care clinical placements undertaken by undergraduate paramedic students participating in the Wicking Dementia Research and Education Centre's ‘Teaching Aged Care Facilities Program’. Benefits of the placement in facilitating the development of critical interpersonal skills are identified and discussed.Setting:A cohort of final year undergraduate students (n=31) completed a five-day clinical placement in four participating residential-aged care facilities in Tasmania, Australia.Method:The research involved the collection of qualitative data during student feedback meetings at the end of students' placements. The data were analysed using a thematic analysis approach. Additionally, quantitative data from pre- and post-placement surveys were collected and analysed using IBM SPSS Statistics 20.0.0.Results:The research found that students benefited from the placement in terms of developing their interpersonal skills. Students demonstrated an increased understanding of dementia and improved communication strategies for working with people with dementia.Conclusions:Paramedic clinical placements in residential-aged care facilities address two key issues identified by the Australian Learning and Teaching Council, these being a lack of interpersonal skills among graduate paramedics and a shortage of alternative learning sites.

Pain: understanding the biopsychosocial model and the paramedic's role within the multi-disciplinary team

Pain, and its consequent management, is a major factor in today's ambulance service, with up to 50% of patients reporting pain among their symptoms when contacting the emergency service. This article explores the role of the paramedic within the multi-disciplinary team and asks the question: ‘What is the appropriate treatment?’ A study of the biopsychosocial model shows that modern clinicians who focus solely on the biomedical model are under-treating the patient's pain by ignoring the psychological and sociological aspects. All this belies a culture of pain management where recognition and treatments of painful conditions bias heavily on some diseases while ignoring or dismissing others. This can, in the eyes of patients, make the individuals complicit with the neglect of painful and life-altering conditions that may permanently change the patients focus and aspirations for the future, and disconnect the patient from the people that are there to help them.

Exclusive look at the College of Paramedics Post-Registration Career Framework

The third edition of the College of Paramedics Post-Registration Career Framework has been prepared to provide stakeholders with comprehensive national standards concerning the educational standards for paramedics throughout the UK. Graham Harris, director of professional standards, College of Paramedics, highlights how it represents an important contribution by the professional body to ensure patient safety

The postgraduate paramedic: meeting the demands of an evolving profession

As the role of the paramedic continues to develop to reflect changing demands in health care provision, the number of staff undertaking postgraduate degrees is on the increase. Ian Peate considers the potential benefits of being educated to Master's level, as well as the impact it has on the individual and the profession.

The Blue Light Fight: making a stand for independent ambulance providers

The Blue Light Fight is the Independent Ambulance Association's (IAA) campaign to stop legislation rushed into law before the general election that would prevent independent ambulance providers from using certain driving exemptions. Penny Bustin, director of communications at the IAA, explains how the campaign is at the very heart of what motivates members: the need to save lives.

Continuing Professional Development: Acute community-acquired pneumonia

OverviewThis Continuing Professional Development (CPD) module will explore acute community-acquired pneumonia (CAP). The pathophysiology and epidemiology of CAP will be discussed, before highlighting key diagnostic features and how it can be managed by paramedics in the pre-hospital setting.Learning OutcomesAfter completing this module you will be able to:Outline the definition, pathophysiology and epidemiology of acute community-acquired pneumonia.Identify the key diagnostic features of acute pneumonia, including the causes and physical presentation.Outline how acute community-acquired pneumonia can be managed by paramedics.

In the footsteps of Dominique Larrey

The Larrey Society is the first cross-sector ‘think tank’ established to help shape the future policy of emergency medical services. David Davis, the society's founder provides a background to the organisation and its inaugural conference being planned for early in 2016.

Offering support to ambulance staff

The Ambulance Services Charity (TASC) has been established as the leading UK charity providing advice and support services to current and retired ambulance personnel and their families and dependents in times of difficulty and urgent need.

Book Review

ABC of Transfer and Retrieval MedicineThe advent of regional trauma networks has transformed the way in which critically injured patients are managed in this country and as always, the pre-hospital phase of critical care has evolved accordingly. Not such a new development internationally, but a common theme globally, is the concept of the transfer and retrieval of critically ill and injured patients between treatment centres.Given the geographic and logistical challenges which exist in this country of admitting a patient directly to a definitive treatment centre, transfer and retrieval medicine represents a contemporary issue of some importance. Not unique to these shores of course and an international perspective is offered, particularly in relation to the composition of air crew and modes of transport available. But commonality exists across a number of areas including the physiology and pharmacology of transfer medicine and generic clinical considerations, all of which are considered in this volume.A large proportion of the paramedic workforce may not have had a great deal of exposure to this area of critical care and as always, the ABC approach effectively identifies the principal areas, all be it on a very superficial level. Where this inevitably leaves the reader short is any in-depth analysis of individual patient groups and medical conditions requiring a very specific type of care. The ‘softer’ aspects are not neglected, though an equally brief resumé is presented, considering non-technical skills, teamwork and ethical perspectives among other things—relevant, but considerably more complex than is allowed for in these pages.Well-informed content, experienced contributors in this particular field of medicine and a readily digestible read. A familiar note? You know by now not to expect detailed analysis from this format but a recommended read for those looking to develop a broad understanding of transfer and retrieval medicine.

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