Clinical Practice

Self-extrication in road traffic collisions: do we really need to cut the roof off?

This literature review incorporates two principal searches. Initially the review interrogated the Ovid Medline database, with search terms including ‘extrication’, ‘movement’, ‘pre-hospital’ and...

Essex and Herts Air Ambulance: a focused case series for pre-hospital practice Case 3: a femoral shaft fracture

A 23-year-old woman who, while crossing the road, was hit by a car coming towards her from her right side. Witnesses reported that the car drove over the patient and dragged her a few yards down the...

Palliative emergencies in the pre-hospital setting

The evidence base for the treatment of palliative patients by paramedics is still limited. However, recent publications by Brady (2012a; 2012b; 2012c), Gakhal et al (2011), Pettifer and Bronnert...

Experiences of two paramedics deployed to the Phillipines in response to Typhoon Haiyan

It is heartening to see the world rally together to assist in devastating events such as this. Many countries immediately mobilised resources in various capacities. The United Kingdom, small island...

Pre-hospital paediatric seizures: midazolam versus diazepam

The aim of this article is to review the evidence for the use of diazepam and midazolam, and to determine which anticonvulsant is the most appropriate for termination of paediatric seizures by...

Ministerial approval for commencement of work on paramedic prescribing

The Allied Health Professions (AHP) Medicines Project is a joint initiative by NHS England and the Department of Health to extend prescribing, supply and administration of medicines to Allied Health...

Rapid sequence induction and the paramedic

Rapid sequence intubation/induction (RSI) is an advanced procedure not currently advocated for UK paramedic practice although some paramedics attached to Helicopter Emergency Medical Services (HEMS)...

Pre-hospital assessment and treatment of meningococcal meningitis

Because bacterial meningitis is life-threatening, early diagnosis and treatment is vital (Brouwer et al, 2012)—the necessity of which is underlined in a study that demonstrated an association between...

Recipe for success: baking in Boston strong-observations on Boston's success

The response to the 15 April, 2013 Marathon Bombing was not a fortunate event. Nor were the stars just perfectly aligned for a lucky response. In fact, the foundation of a successful response is built...

Documentation: are we writing it right?

‘The quality of your record-keeping is also a reflection of the standard of your professional practice. Good record-keeping is a mark of a skilled and safe practitioner, while careless or...

Pre-hospital lactate monitoring for adults with sepsis

Sepsis is a life-threatening condition with estimates of up to 37 000 deaths annually in the UK alone. When sepsis is not treated the mortality rate increases by 8% every hour (Cronshaw et al, 2011)....

A brief history of analgesia in paramedic practice

Important advances in the prevention and management of pain occurred in the mid-1800s, when drugs that produced anaesthesia were first used during surgery. These drugs included nitrous oxide, ether...