RCSEd Consensus Documents: improving the evidence base for pre-hospital practice

Pre-hospital care comes in many guises and is one of the most exciting areas of current medical practice. Increased demands are being placed on the teams who provide this vital service, and its development is an important factor in delivering better patient care.

This editorial is to introduce these consensus documents and to describe the on-going process that the Royal College of Surgeons of Edinburgh Faculty of Pre-hospital Care (RCSEd FPHC) is utilising to improve the evidence base for pre-hospital practice.

In the pre-hospital context the response teams are doing all they can to save lives. A terrifying ordeal or horrific accident comes without warning at any time of the day or night. With lives at risk, the rescue and pre-hospital care teams need to work fast and in harmony with each other. Everyone has to be clear about their role, with multi-agency teams working seamlessly together. Each situation is unique and may present real dangers; not just for the patient but also for the medics. Blending of services within health and social care allows for the provision of meaningful governance with timely and appropriate interventions throughout the patient pathway. To enable this, many of the processes need to be well thought through and described beforehand, allowing all to work through the same methodology towards a common goal. The consensus process is one tool in the decision-support process. The development of these guidelines needs to follow a transparent system to result in the best evidence-supported practice that is auditable and accountable, balances risk and benefit in most circumstances and remains financially viable.