management

Best practice technique in intramuscular injection

In this month's Clinical Skills article, best practice for the administration of intramuscular (IM) injections will be discussed. It is important to re-visit clinical skills as many are taught during...

Traumatic cardiac arrest: what's HOT and what's not

Treatment and management is increasingly being directed at the rapid identification and reversal of potential causes. Reversing hypovolaemia, oxygenation and tension pneumothorax (HOT) as a priority...

Intraosseous access: a safe alternative route

IO infusion is a method of administration of medications or fluids directly into the marrow of a bone (Figure 1)..

Pre-hospital management of major haemorrhage following trauma: part one

Bleeding within the body affects two principal physiological systems:.

Airway management and endotracheal intubation by paramedics for cardiac arrest

Paramedics are trained in airway management, including in the skill of endotracheal intubation (ETI) in practice. Guidance is available to support paramedics regarding when and how ETI should be...

Combat Application Tourniquet: best practice use

A ‘tourniquet’ or CAT is a device designed to specifically occlude arterial and venous blood flow in an extremity. To do this, it uses a mechanical advantage device, differing from ligature type...

A review of ketorolac as a prehospital analgesic

Ketorolac is an NSAID, which has its action through the inhibition of prostaglandin synthesis. As an NSAID, ketorolac inhibits the action of the cyclooxygenase enzymes (COX-1 and COX-2), which...

Reduction of a finger in the out-of-hospital arena?

Kovacs and Croskerry (1999) point out that clinicians use a variety and range of clinical decision-making approaches. These are dependent largely on the unique characteristics of individual clinical...

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...

Non traumatic chest pain – pericarditis

‘Pericarditis is an inflammation of the two layers of the thin, sac-like membrane that surrounds the heart. This membrane is called the pericardium, so the term pericarditis means inflammation of...

Ultrasound: A potential new approach for cardiac arrest management

Eight studies were evaluated to review the use of pre-hospital ultrasound. The OHCA studies reviewed evaluate the use of US both in and out-of-hospital. The evidence was reviewed using the Critical...

Appropriate pain assessment tools for use in patients with dementia in the out-of-hospital environment

Defining pain is complex; however, it is generally agreed to be an unpleasant, emotive and personal experience (Briggs, 2010; Steeds, 2013). Pain is generally split into two categories: nociceptive...