I won't be breaching any literary boundaries by suggesting that the nature of paramedic practice has evolved beyond recognition in the past four decades. But one literary work which may just do that is the ever-present Emergency Care in the Streets. First published back in 1974, this was seen as the text to accompany the very first national curriculum for paramedic training in America—the content of which can also be attributed to the book's author.
So has this 7th edition stood the test of time and has it successfully followed on from previous editions and navigated any trans-Atlantic differences? A brief glance at the editors answers the latter question, as a most impressive ensemble of practitioners and educators have ensured the content is contemporary and relevant for a UK-based readership. An extensive list of reviewers also helps to that end.
So what of the content? With a sense of nostalgia I had a cursory glance at the 5th edition of this book which sits proudly, if not a little idle, on my bookshelf. A measure of how dated it has become is evident as it celebrates the inclusion of pulse oximetry, 12-lead ECGs and metered-dose inhalers. Fast forward from 1995 to this 7th edition and topics such as pharmacology and concepts such as scope of practice and clinical negligence have made their way onto the contents page. Less celebrated subject areas such as terrorism and safeguarding vulnerable patients have regrettably, although justifiably, also been introduced.
All familiar territory to paramedics these days and the latest edition of Nancy Caroline's legacy has kept pace. A further update with this 7th edition is the inclusion of ‘Assessment in Action’ and ‘Skills Drills’ sections, which help to put some context on the preceding chapter's content, with the introduction of a ‘virtual vocabulary’ at the end of each chapter—a nice touch for novice medics.
Appropriately updated, a coherent structure and neat layout help to forgive the occasional Americanism. One sentiment, however, which should transcend any continental differences is the assertion that you are not just a paramedic for your shift—it is a vocation. A touch on the poetic side perhaps, but difficult to argue the contrary.
It really is remarkable that any clinical text is able to retain its relevance and standing in the profession after 40 years or so in publication, made all the more poignant as the original author died prematurely at the age of 58 in 2002. Testimony to the calibre of her work, it should come as no surprise that the profession continues to endorse Nancy Caroline's inclusion on reading lists and education programmes