Clinical Practice

Best practice technique in intramuscular injection

In this month's Clinical Skills article, best practice for the administration of intramuscular (IM) injections will be discussed. It is important to re-visit clinical skills as many are taught during...

Hand hygiene compliance in the pre-hospital setting

Health professionals' compliance with hand hygiene remains a universal problem in health care (Gould et al, 2017; Sunley et al, 2018). While poor hand hygiene is prevalent in the inpatient and...

Using haemostats effectively in pre-hospital care

The purpose of this month's Clinical Skills column is to provide safe and effective best practice guidance for the use of haemostatic agents, or haemostats, in the pre-hospital environment. The topic...

Traumatic cardiac arrest: what's HOT and what's not

Treatment and management is increasingly being directed at the rapid identification and reversal of potential causes. Reversing hypovolaemia, oxygenation and tension pneumothorax (HOT) as a priority...

Intraosseous access: a safe alternative route

IO infusion is a method of administration of medications or fluids directly into the marrow of a bone (Figure 1)..

Capnography: monitoring CO2

The content of the air we breathe is a mixture of gases, with each gas exerting a pressure dependent on its proportional size. This is called its partial pressure and is abbreviated as the letter ‘P’,...

Pre-hospital management of major haemorrhage following trauma: part one

Bleeding within the body affects two principal physiological systems:.

Pulse oximetry: SpO2 and SaO2

Arterial oxygen saturation or the discovered oxygen level in arterial blood (SaO2) is invasive, and it is difficult to monitor trends in a practice setting. In 1972, the idea of a non-invasive pulse...

Peak expiratory flow rate

Peak expiratory flow rate (PEFR) is the volume of air forcefully expelled from the lungs in one quick exhalation. It is a reliable indicator of ventilation capacity as well as airflow obstruction...

Airway management and endotracheal intubation by paramedics for cardiac arrest

Paramedics are trained in airway management, including in the skill of endotracheal intubation (ETI) in practice. Guidance is available to support paramedics regarding when and how ETI should be...

Combat Application Tourniquet: best practice use

A ‘tourniquet’ or CAT is a device designed to specifically occlude arterial and venous blood flow in an extremity. To do this, it uses a mechanical advantage device, differing from ligature type...

A review of ketorolac as a prehospital analgesic

Ketorolac is an NSAID, which has its action through the inhibition of prostaglandin synthesis. As an NSAID, ketorolac inhibits the action of the cyclooxygenase enzymes (COX-1 and COX-2), which...