Letters to the Editor

Response to Johnston (2016) Journal of Paramedic Practice 8(1): 36–40Dear editor,Johnston (2016) makes a convincing argument for an app to assist paramedics in the guidance for suitable care pathways after diagnosing overdose of ‘Legal Highs’ and is a worthy winner of the student medical poster competition. I would be grateful if he considered further improvements to his app concept and the web-based content supporting it.He correctly identifies the difficulties with updating rapidly changing and geographically differing information about the various substances. I heard from a freelance colleague on the south coast of an app awaiting licensing and some development for the more mainstream recreational drugs. This app has input from police/Government chemical analysts and is updated to give local information. With a highly mobile population, it may be helpful to identify a purchase location or web address to assist in identifying the strengths and composition of the widely varying substances, as identified by Home Office laboratories. Paramedics could add to this process by an employer controlled means of collecting randomised data—for example: ‘herbal ecstasy, Bristol, hypotension resistant to fluid bolus.’ This would be relatively easy for updating to the app via either clinical support desk or directly via users themselves. Part of the database supporting the app would, of course, need to have supplier web location and/or street location information sources.The second improvement would be the use of a ring binder rather than bound book, in much the same way UK Ambulance Services Clinical Practice Guidelines used to be provided. This would enable printing of updated information to be rapidly added to the guidelines by those paramedics without smart technology. With the increased roll out of electronic patient report forms, this of course becomes less of an issue, as the app could easily be incorporated into this new technology.Johnston has used two current topics of direct interest for paramedics to attempt to improve patient outcomes. Let us hope his imaginative and ingenious thinking continues. Full credit to him in the earliest stages of his career.

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