assessment

Clinical suspicion regarding needle decompression for patients with chest trauma

Needle decompression of the chest (also known as thoracocentesis or thoracentesis) is a manoeuvre to release abnormal air from the pleural space. Prehospital needle decompression is only indicated for...

Decision making for patients categorised as ‘amber’ in a rural setting

The study explored the experiences of paramedics working in rural areas. A qualitative design was used to provide depth and richness. Data were analysed through inductive thematic analysis (Braun and...

Point-of-care blood tests in decision-making for people over 65 with acute frailty

National ‘see, treat and discharge’ rates for paramedics have increased since the Taking healthcare to the patient report was issued in 2005 (Department of Health and Social Care (DHSC), 2005), with...

Human factors, cognitive bias and the paramedic

Much of the evidence surrounding human factors and cognitive bias comes from the hospital or primary care environment. There appears to be little evidence looking specifically at human factors in the...

Correct pulse measurement

When the heart contracts and blood is ejected from the left ventricle, a pressure wave is generated and transmitted into the aorta and arterial tree. The flexible and elastic nature of artery walls...

Recognising ECG landmarks

Electrocardiograms (ECGs) have become an integrated part of an ambulance clinician's toolkit, with thousands being performed each year (Brady et al, 2012). Invented in 1903 by Willem Einthoven, a...

A brief guide to borderline personality disorder in an emergency setting

OverviewParamedics and ambulance staff are frequently in contact with patients who have mental health diagnoses This may be the primary reason for contacting the emergency services (e.g. self-harm,...

Point-of-care ultrasound use in the pre-hospital setting

Since its introduction, POCUS has been used to enhance the assessment of a wide range of clinical conditions across medical and traumatic pathologies. For example, the ‘focused assessment with...

Measuring blood pressure and monitoring patterns

Systolic pressure is the force of BP on arterial walls at the end of ventricular contraction, i.e. in systole (Tortora and Derrickson, 2017). Diastolic pressure is the force exerted by the remaining...

Pulse oximetry: SpO2 and SaO2

Arterial oxygen saturation or the discovered oxygen level in arterial blood (SaO2) is invasive, and it is difficult to monitor trends in a practice setting. In 1972, the idea of a non-invasive pulse...

Cardiac arrest and the role of transthoracic echocardiography

Massive acute pulmonary emboli (PE) is a reversible cause of cardiac arrest, with thrombolysis being the first line of treatment (British Thoracic Society, 2003). Occlusion of pulmonary blood flow is...

Stroke assessment and management in pre-hospital settings

The World Health Organization (WHO) defined a stroke as a ‘a clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cerebral function...