Clinical Practice

Hyperventilation in cardiac arrest—a systematic review and narrative synthesis

Background: Resuscitation guidelines recommend delivering ventilations at a rate of 10 per minute. However, hyperventilation is commonly reported during out-of-hospital cardiac arrest resuscitation efforts, and the impact of this on patient outcomes is unclear. This review explores the reported rates, causes and patient outcomes of hyperventilation in the management of out-of-hospital cardiac arrest. Methods: A systematic literature review with a narrative synthesis of three databases was...

Prehospital use of the paediatric observation priority score

Background: In the prehospital setting, the incidence of seriously unwell children is low and emergency medical staff have repeatedly expressed concerns about their confidence and knowledge with regard to assessing children. The paediatric observation priority score (POPS) was designed in response to concerns about the identification of seriously unwell children. The ambulance service in this study began to implement POPS in 2018. Aim: To examine the use and documentation of POPS by ambulance...

Allied health professional confidence in giving prehospital fascia iliaca blocks

Background: Fascia iliaca blocks (FIBs) are an efficacious form of prehospital regional anaesthesia for patients with neck of femur fracture. Current prehospital use is limited. Aims: The primary aim of this study was to assess procedural confidence among allied health professionals. The secondary aim was to examine concerns related to prehospital use of FIB. Methods: This was a qualitative study that analysed semi-structured interviews. Two recognised groups were involved: paramedics and...

Challenges of prehospital silver trauma patients

Silver trauma patients, defined as those aged >65 years who have traumatic injuries, are a complex group because physiology alters with age leading to difficulties with assessment. This is exacerbated within the prehospital setting as environmental factors and ambulance delays increase the risk of complications. This article focuses on the pathophysiology and application of clinical guidelines on three aspects of prehospital silver trauma: neurology, osteology and haemorrhage. Neurologically,...

Prehospital emergency health services in Qatar

The provision of prehospital emergency healthcare around the world varies greatly. Each country implements a delivery model according to its own economy, population, culture, policy and geography, including Qatar. In the past decade, in preparation to host the FIFA 2022 World Cup, significant technological investments have been made to improve and develop the country's prehospital emergency health services. This article is based on an academic visit of two Turkish academics with an interest in...

Attempting to prevent hyperoxaemia after out-of-hospital resuscitation

Survival to discharge in the UK after an out-of-hospital cardiac arrest is significantly lower than in other similarly developed countries (7.3% in the UK compared with the rest of Europe at 11.7%). One modifiable factor that could be contributing to this is the oxygen administered by paramedics after a successful out-of-hospital resuscitation. Randomised controlled trials on the topic are limited, and most research is observational and often does not differentiate according to the location of...

Prehospital management of sickle cell crisis: a case report

Sickle cell disease (SCD) covers a group of inherited conditions that affect the red blood cells. It can cause episodes of intense pain called sickle cell crises. This case study outlines a 10-year-old boy's first presentation of sickle cell crisis. The patient presents with typical sickle cell crisis pain in joints that is exacerbated by movement and related to strenuous physical exercise in the cold. This pain is caused by the sickled red blood cells occluding the microvasculature, causing...

Paramedic decision-making and the influence of bias: a case study

Background:Prehospital clinical decision-making is a complex, evolving skill. Typically, there are multiple possible diagnoses and several potential treatment pathways to be considered, and usually prehospital clinicians have to base their decisions on imperfect information. Biases will inevitably compete to influence clinicians as they attempt to weigh the probabilities of diagnoses, degrees of certainty and permissible risks in their decision-making process. With experience, as intuition and...

Keep up to date with Journal of Paramedic Practice!

Sign up to Journal of Paramedic Practice’s regular newsletters and keep up-to-date with the very latest clinical research and CPD we publish each month.

© Copyright 2023 MA Healthcare Ltd | All rights reserved