patient safety

Assessment and management of issues in early pregnancy

Common benign causes of abdominal pain include bloating, constipation and round ligament syndrome (Hopcroft and Forte, 2003)..

Patient-centred prescribing, autonomy and concordance

The following patient example provides a framework for discussion. The patient's name has been changed to ensure confidentiality, and only the information relevant to this article is presented. The...

Happy hypoxia in COVID-19: pathophysiology and pulse oximetry accuracy

Dyspnoea is characterised by the sensation of uncomfortable or difficult breathing, breathlessness or experiencing air hunger (American Thoracic Society, 1999)..

COVID-19: experiences of roadside logistics from a UK air ambulance service

Symptoms of COVID-19 were initially described as being flu-like, with a persistent cough and shortness of breath as leading features. A loss of smell or taste has also since been identified as a...

A rare condition with excellent outcome—if treated correctly: examining cardiac arrest from accidental hypothermia

I have been actively involved with accidental hypothermia since 2011, have co-authored several publications, lectured and recently updated the hypothermia section in the JRCALC Clinical Guidelines. I...

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...

Prehospital emergency anaesthesia: time taken to care for and respond to a critically injured patient

One of the first questions raised when researching PHEA is: what is it best referred to as? The SOP produced by Pinnell and Pountney (2015), followed by the ambulance trust, is so titled, but refers...

Does digoxin cause more harm than good?

Digoxin has a very narrow therapeutic margin between toxicity and efficacy, which results in a high incidence of digoxin toxicity (Larsen, 2009). To avoid toxicity, digoxin dosage must be adjusted...

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...

Hand hygiene compliance in the pre-hospital setting

Health professionals' compliance with hand hygiene remains a universal problem in health care (Gould et al, 2017; Sunley et al, 2018). While poor hand hygiene is prevalent in the inpatient and...

‘Have you had Viagra within the past 24 hours?’

Glyceryl trinitrate (GTN) is a nitric oxide (NO) donor, which can be used to provide immediate relief for cardiac chest pain, and lower blood pressure. Cardiac chest pain is usually as a result of...

Paramedic management of out-of-hospital postpartum haemorrhage with TXA

The RCOG (2009) recognises that PPH is the leading cause of obstetric haemorrhage and suggested that the incidence of PPH is rising in the UK. Sentilhes et al. (2015a) outlines that PPH, of either...