Clinical competencies in pre-hospital critical care

This study examines the clinical competencies of paramedics, critical care paramedics (CCP) and critical care doctors (CCDr) practising within the former Great Western Ambulance Service (GWAS). Between September 2012 and January 2013, researchers reviewed standard operating procedures, professional guidance documents, equipment available to the practitioner and clinical records, as well as conducting direct observations and surveying each professional group to determine their clinical competencies.

For the paramedic group, competencies were drawn from the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) Guidelines (2006). Standard double-crewed ambulance equipment and the contents of the paramedic drug pack were also scrutinised.

CCP competencies were obtained from JRCALC guidelines, GWAS Critical Care Team (CCT) Standard Operating Procedures (SOPs), and equipment and drugs available to that team.

CCDr competencies were obtained from the Intercollegiate Board for Training in Pre-hospital Emergency Medicine curriculum framework and GWAS Critical Care Team SOPs.

For all professional groups, a convenience sample of patient care forms (PCF) were reviewed and direct observation undertaken by a researcher. Saturation was defined as 10 consecutive PCF analyses or five direct observations not revealing any new competencies.