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Non-medical prescribing by paramedics in emergency, urgent and critical care

02 May 2021
Volume 13 · Issue 5


This article considers some of the unique considerations and challenges that are associated with non-medical prescribing in the context of paramedic emergency care. In contrast to primary care, advanced paramedics practicing in emergency settings are more likely to encounter patients who require an immediate supply or administration of medication and access to a range of controlled drugs. Furthermore, access to medical support for prescribing decision-making, restrictions on the prescribing of controlled drugs and potential challenges in obtaining access to patient records, may also impact non-medical prescribing in these settings. Currently, very little empirical evidence has been published on the topic of non-medical prescribing in paramedic practice. Further research is required to understand whether the anticipated benefits are being realised for patients and NHS services. This is particularly the case in the context of prehospital emergency, urgent and critical care settings.

Non-medical prescribing in now being adopted by advanced-level paramedics in a range of settings (Rovardi, 2019; NHS England, 2018a). These settings include primary care, secondary care, emergency departments and ambulance trusts (Hilton et al, 2019; College of Paramedics (CoP), 2021).

This article in the Prescribing Paramedic series considers some of the unique considerations and challenges that are associated with paramedic prescribing in the context of emergency departments and prehospital settings.

Within these settings, paramedics undertaking non-medical prescribing may encounter a range of issues and challenges. These include situations where simultaneous prescribing and administration or supply of medication is required, alongside restrictions to the prescribing of controlled drugs, insufficient access to patient records and obtaining medical support (Bedson and Latter 2018; Hilton et al, 2019; Stenner et al, 2019; Clarke 2019).

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