Leadership and Management

Taking a holistic approach to acute mental health crisis

Wednesday, October 2, 2019

An innovative, collaborative model implemented by a UK ambulance service allows patients presenting with a mental health condition to be promptly assisted by a specialist team comprising a paramedic, mental health nurse and police officer. Initial evidence suggests that greater collaboration between emergency services and mental health trusts benefits patients and services: leading to timely assessments, reductions in patient distress levels, and decreasing emergency department overcrowding...

Prehospital use of the traction splint for suspected mid-shaft femur fractures

Introduction: A retrospective audit of electronic patient care records (ePCRs) highlighted the infrequent use of the traction splint for the management of femur fractures. The aim of this study was to improve the use of the traction splint for patients presenting with a mid-shaft femur fracture in the absence of contraindications, by means of introducing a purpose-designed trauma CPD training course. Methods: An intervention consisting of a simulation-based mandatory trauma CPD training...

The impact of paramedic shift work on the family system: a literature review

Aim: The current review investigates the impacts of paramedic work on the family system. Paramedics are taking time off or leaving through stress, and career decisions could be influenced by this perceived impact. Method: A systematic literature review was conducted and the literature critiqued. Two themes were identified: emotional labour and work-family fit. Results: Paramedics rely on families for emotional support, putting them at risk of vicarious trauma. The historical male coping...

Scoping ambulance emissions: recommendations for reducing engine idling time

The NHS is a significant contributor to the UK's greenhouse gases and environmental pollution. The current review seeks to examine the degree to which ambulance services contribute to environmental pollution and provides quality improvement suggestions that may reduce emissions, save money and improve public health. A literature search was conducted to identify the English language literature for the past 7 years related to ambulance service carbon emissions and pertinent strategies for reducing...

Advanced prehospital stroke triage in the era of mechanical thrombectomy

Direct transport to a comprehensive stroke centre that is capable of endovascular thrombectomy may improve outcomes in patients with large vessel occlusive stroke. A number of prehospital triage tools have been developed to see if clinicians can predict which patients would benefit from this procedure, allowing them to bypass a primary stroke centre in preference for a comprehensive stroke centre. A literature search was performed across a number of medical databases; six triage tools were...

What is the paramedic's role in smoking cessation?

Background: Both the National Institute for Health and Care Excellence (NICE) and Public Health England have made smoking cessation a health promotion priority but the paramedic's potential impact in this important area has yet to be fully realised. Aim: This article proposes an evidence-based quality improvement intervention that can be adopted by paramedics at an individual, service-wide or national level to promote smoking cessation. Methodology: Building on a structured literature...

Leadership in training: a Q&A with Ian Corrie

As well as the use of practical clinical scenarios, the training weekend was also used to provide leadership and development training for senior members of the regiment. In this special Question and Answer feature, the man in charge, Ian Corrie, provides a more in-depth insight into what the training involved

A Guide to the Mental Capacity Act for Paramedics

The Mental Capacity Act 2005 is one of the key pieces of statutory legislation used in modern paramedic practice. To the unprepared, the Act can seem complex and daunting; but it is a powerful tool which helps paramedics to deal with often complex and challenging situations in a way which is both ethically and legally safe. What follows is a walk-through of the Act itself looking at the parts which are relevant to paramedic practice and discussing issues relating to them which, it is hoped, will...

Breaking bad news and managing family during an out-of-hospital cardiac arrest

The management of family during out-of-hospital cardiac arrests and death notification to the family of the deceased in the out-of-hospital setting are topics that are poorly evidenced. Two focus groups consisting of six participants in each were conducted, discussing the two subjects. The results suggest that paramedics prefer family not to be present in the room for a number of reasons and that they don't feel sufficiently trained by their paramedic courses in order to manage family during...

Care pathways for low-risk transient ischaemic attack

Background:In secondary care, the urgency of review for transient ischaemic attack (TIA) has relied upon the use of the ABCD2 score, but this tool is not validated for use by emergency ambulance crews. There is a need to evaluate alternative care pathways for patients who might be eligible for direct referral to TIA clinics without prior conveyance to the emergency department (ED).Aim:The aim of this national survey was to describe current service provision across the UK for pre-hospital...

Why do paramedics have a high rate of self-referral?

Paramedics have been regulated in the UK since 2003. Analysis shows that the profession has had consistently higher rates of self-referral to its regulator compared with other health and care professions. Between 2013 and 2016, the percentage of paramedics who self-referred averaged 50% of all cases, compared with 6% across all other health professions regulated by the Health and Care Professions Council (HCPC) and 10% across social workers in England. This article reports on possible reasons...

Smaller, lighter, faster? Reducing the carbon footprint of ambulances

This paper outlines a feasibility project investigating the potential for smaller, lighter rapid response vehicles (RRVs) in reducing the carbon footprint and response times of ambulances. Five stakeholder consultations were held with two ambulance trusts, an ambulance manufacturer, a paramedic and the Ultra-Light Vehicle Group to generate three novel design concepts for RRVs, which were then reviewed by four UK fleet managers and four clinicians. The results indicated that the integrated...

Cardiac arrest resources that improve patient outcomes

Survival rates for out-of-hospital cardiac arrest (OHCA) patients in the UK are low compared with other developed countries. UK ambulance services are in an important position to influence these survival rates by improving their ‘chain of survival’ (Nolan et al, 2006). A paramedic-led resource, with enhanced technical and non-technical skills specialising in OHCAs, has been shown to improve patient outcomes in this population group in the UK. The author proposes that this concept should be...

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