Emergency primary and secondary systems of assessment

Life-threatening emergencies, while stressful, are not experienced by prehospital clinicians all that often (Wardrope and Mackenzie, 2004). Of the 9.2 million 999 calls received by NHS ambulance services in England in 2019–2020: 30 908 required cardiopulmonary resuscitation by an ambulance crew; 6379 were diagnosed with ST-elevation myocardial infarction; 34 599 were assessed for a stroke; and 33 896 were suspected to have sepsis (NHS, 2021). These account for just over 1% of all 999 calls received in this period.

Therefore, many of the patients who call 999 are not experiencing an easily recognisable life-threatening condition. However, reports into serious untoward incidents have shown that some are related to the assessment of the patient (London Ambulance Service. 2015; West Midlands Ambulance Service, 2021). To ensure paramedics can recognise and manage these patients, they require training and practice.