Book Review

UK Ambulance Services Clinical Practice Guidelines 2016 Pocket Book

I often spend my time reflecting on what publishers consider pocket-sized. Now this may seem a touch on the trivial side given the contemporary issues currently facing our profession. But consider, if you will, the potential cost savings in uniform issue from burst trouser seams due to bulging pockets (not waist bands).

So to the content. I think it prudent to leave any review of individual drug regimes to the clinical nous of each ambulance service, for which these guidelines were written, and focus more on the structure and philosophy behind them.

It is good to see the ‘page for age’ section has been retained from the 2013 edition. It is a quick and reliable tool for clinicians and is fast becoming the hallmark of these guidelines. Praise is also due for the continued inclusion of valuable decision-making aids such as the National Institute for Health and Care Excellence guidelines for febrile illness, triage models, and a revised mental capacity assessment tool is a welcome addition.

I do, however, remain curious over the inclusion of algorithms for specific medical conditions such as advanced life support and convulsions. More suited to the larger book version of the guidelines than the pocket guide, as paramedics should be well-versed in these. And the ubiquitous picture of a skeleton is questionable.

On that note, I feel compelled to enter the debate concerning the use of these clinical guidelines in paramedic practice. In truth, the former informs the latter. Regional variations relating to patient group directives will doubtless exist, but the ability for paramedics to have this clinical aid to hand is invaluable. As I reflected 3 years ago, this pocket book should enhance, not replace, clinical reasoning and decision-making. Every patient contact has its own unique set of circumstances which cannot be addressed in a pocket guide but use this tool to help.