Clinical Practice

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...

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

These case reports are from prehospital settings and involve patients experiencing traumatic injuries who were attended by rapid response doctors. The cases are from the UK and Ireland..

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...

Acute traumatic coagulopathy: the lethal triad of trauma

The prehospital clinician is often the first to manage a patient with a reduced temperature as a result of loss in circulatory volume caused by trauma so has an important early role in the management...

Splinting of injuries: best practice guidance

A splint is a device that is used to support an injury that has caused a body part (normally an extremity) and the associated joints not to function in a normal manner; it achieves this by...

Tourniquets in the treatment of prehospital haemorrhage

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Correct pulse measurement

When the heart contracts and blood is ejected from the left ventricle, a pressure wave is generated and transmitted into the aorta and arterial tree. The flexible and elastic nature of artery walls...

Hyperventilation syndrome: diagnosis and reassurance

The term hyperventilation syndrome (HVS) was first mentioned in 1938 by Kerr et al who attributed their patients' tetany to hyperventilation associated with anxiety. Since then, the term has been...