An essential series on clinical decision-making on scene

Back in 2004, the Emergency Medicine Journal (EMJ) created a series entitled ‘The ABC of community emergency care’, which was designed to update general practitioners who were experienced in the field and to serve as an introduction to those new to emergency clinical decision-making.

The aim of the series was to describe the management of non-traumatic emergencies commonly encountered in community emergency care. It was aimed at doctors because it was generally GPs who managed patients with urgent care needs in the community.

However, following the changes to GP contracts that came into effect on 1 April 2004, many GPs opted out of providing certain services such as out-of-hours cover. NHS ambulance services became the first port of call for many patients who would previously have contacted their GP, and paramedics were being asked to provide a different level of service to non-emergency patients.

Today, paramedics are the first point of contact for a high number of patients with urgent care needs and it is reasonable to argue that clinical decision-making has never been so important and so challenging.