References
Show me the evidence! Engaging with science in the pre-hospital environment
Paramedic practice in the UK is heavily based on robust and practical clinical guidelines and algorithms. These guidance documents may evolve from local or regionally-derived protocols to systematic national clinical practice guidelines based on current best evidence. Guidelines such as the UK Ambulance Services Clinical Practice Guidelines (Association of Ambulance Service Chief Executives, 2016) are universally adopted as the gold standard of practice. Although such guidelines are based on the premise of evidence-based practice (Joint Royal Colleges Ambulance Liaison Committee and Association of Ambulance Service Chief Executives, 2014), clinical medicine is full of gaps in evidence, not least in the pre-hospital environment where time pressures, clinical urgency, logistics, and complexity may hinder thorough scientific enquiry.
As a profession, paramedics are no longer the ‘ambulance drivers’ of the past; a new cadre of university-educated professional paramedics are now arriving for work with a more sound academic grounding than their generational predecessors. Furthermore, their pre-hospital physician colleagues are fully accredited pre-hospital emergency medicine (PHEM) practitioners with comprehensive PHEM training and on-going requirement for clinical excellence and revalidation. The direction of travel in the pre-hospital environment is one of improvement, optimisation, and professional development of paramedics and physicians alike. This should be integrated into care within seamless clinical pathways reaching into hospital practice and with patient-centred outcomes.
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