Clinical Practice

Physical health in mental health: considerations for paramedics

The World Health Organization (WHO) (2018) identifies three broad areas that influence health:.

Clinical exam: an introduction

The articles are intended to support clinician development and to assist in the overall assessment of patient presentations. The information should be used to support consideration of differential...

Salutogenesis: the case for a holistic tool for paramedic assessment of wellness

Salutogenesis is an approach to conceptualising wellness that examines health as a continuum and considers a multifactorial approach to determining an individual's health status (University West...

Non-invasive ventilation as a prehospital intervention for acute COPD exacerbation

The clinical forms of COPD are chronic bronchitis and emphysema, although guidelines discourage differentiation between the two forms when making a diagnosis (NICE, 2010). Chronic bronchitis is...

Oxygen titration therapy and hypercapnia risk in COPD

Evidence suggests that high amounts of oxygen administered to patients with COPD can lead to hypercapnia (high levels of arterial carbon dioxide), potentially resulting in respiratory acidosis (Perrin...

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...

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...

Managing common end-of-life cancer presentations according to the evidence

For people with cancer who are terminally ill, an unexpected hospital attendance can be distressing and tiresome. Such visits made close to the end of life can be considered an indicator for poor...

Fascia iliaca compartment block: a short how-to guide

FICB is a simple technique, and allows a high quality of analgesia to be given without the side effects of opiate analgesia. FICB is the current gold standard in the management of neck of femur...

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...

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...