Clinical Practice

Methoxyflurane (Penthrox®)—a case series of use in the prehospital setting

  • February 2019

Methoxyflurane (Penthrox®) is a fluorinated hydrocarbon, which when first used in general anaesthesia was noted to have strong analgesic properties in subanaesthetic dosage. More than 5 million doses have been sold for use in Australia since 1978 and have been found to have an excellent safety profile. After rigorous review by the Medicines and Healthcare Regulatory Agency, methoxyflurane was granted a product licence in 2015 in the UK and Europe for the relief of pain in patients with...

Human factors, cognitive bias and the paramedic

  • January 2019

The consequences of human factors and cognitive bias can be catastrophic if unrecognised. Errors can lead to loss of life because of the flawed nature of human cognition and the way we interact with our environment. Seemingly small mistakes or miscommunications can lead to negative outcomes for patients and clinicians alike. It is easy to see therefore why the College of Paramedics now recommends the teaching of human factors at higher education institutions. Using a problem-based approach, this...

Splinting of injuries: best practice guidance

  • December 2018

In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontline, highlighting the importance of these skills and how to perform them. In this instalment, Rory McKelvin discusses the application of splints to fractures and sets out a best practice step-wise approach to assessment, decision-making and application in prehospital settings

Acute traumatic coagulopathy: the lethal triad of trauma

  • December 2018

Trauma is the leading cause of death for people in the UK and North America, especially for those aged 15–24 years. However, if early management regimes of permissive hypotension, high-flow oxygen and administration of tranexamic acid are applied, mortality risk can be reduced significantly. Acute traumatic coagulopathy (ATC) is an internal process that is initiated by significant or massive trauma because of hypoperfusion resulting in hypovolaemic shock, activation of protein C, platelet...

Correct pulse measurement

  • November 2018

In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontline, highlighting the importance of these skills and how to perform them. In this month's instalment, Andrew Kirk discusses common pulse sites and correct technique for obtaining a patient's pulse

Tourniquets in the treatment of prehospital haemorrhage

  • November 2018

Background:During recent conflicts in Iraq and Afghanistan, tourniquets were a useful tool in the management of non-compressible prehospital catastrophic haemorrhage. Recommendations for use within the civilian setting were then made. However, civilian research supporting this change in practice is limited.Aims:The aim of the research is to evaluate the utility of prehospital tourniquet application through description of the complications associated with use, as well as identification of...

Hyperventilation syndrome: diagnosis and reassurance

  • September 2018

This article provides an overview of hyperventilation syndrome (HVS). Hyperventilation is to breathe in excess of metabolic requirements; in the absence of an underlying organic cause, it is defined as HVS. Alternative terms used in literature are panic or anxiety attack, panic or anxiety disorder, dysfunctional breathing and breathing pattern disorder. This article explores HVS signs and symptoms beyond the familiar clinical signposts of tachypnoea, chest tightness, paraesthesia and anxiety. It...

Recognising ECG landmarks

  • September 2018

In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontline, highlighting the importance of these skills and how to perform them. In this instalment, Karen Simpson-Scott takes an in-depth look at electrocardiograms and the vital readings they provide for clinicians

A brief guide to borderline personality disorder in an emergency setting

  • August 2018

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, crisis or suicide ideation) or it may be incidental to their primary clinical concern. Patients in mental health crisis can be challenging and demanding. Most paramedics will not have had specific guidance on identifying or understanding the features, aetiology and responses to treatment of patients...

Best practice technique in intramuscular injection

  • July 2018

In each issue, the paramedic education team at Edge Hill University focuses on the clinical skills carried out by paramedics on the frontlines, highlighting the importance of these skills and how to perform them. In this issue, Andrew Kirk discusses the administration of intramuscular injection in pre-hospital care in line with best practice.

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