• Effectiveness of paramedic practitioners in attending 999 calls from elderly people in the community: cluster randomised controlled trial

      Mason, Suzanne; Knowles, Emma; Colwell, Brigitte; Dixon, Simon; Wardrope, Jim; Gorringe, Robert; Snooks, Helen; Perrin, Julie; Nicholl, Jon (2007-11)
      Objective To evaluate the benefits of paramedic practitioners assessing and, when possible, treating older people in the community after minor injury or illness. Paramedic practitioners have been trained with extended skills to assess, treat, and discharge older patients with minor acute conditions in the community. https://www.bmj.com/content/bmj/335/7626/919.full.pdf This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/bmj.39343.649097.55
    • How do paramedics learn and maintain the skill of tracheal intubation? A rapid evidence review

      Pilbery, Richard (2018-09)
      Abstract published with permission. Introduction: Endotracheal intubation has been considered a core skill for all paramedics since the inception of the profession in the 1970s, and continues to be taught within the majority of pre-registration paramedic training programmes. However, the standards of both training and assessment of competence in intubation vary considerably between institutions; this has been compounded by reduced opportunities for supervised clinical practice within the operating theatre environment. The College of Paramedics’ Airway Working Group commissioned a rapid evidence review, to inform a consensus statement on paramedic intubation, with the research question: How do paramedics learn and maintain the skill of tracheal intubation? Methods: Rapid evidence reviews are literature reviews that use methods to accelerate or streamline the traditional systematic review process. Randomised controlled trials, quasi-randomised controlled trials, prospective and retrospective observational studies, systematic reviews and qualitative studies, published from 1970 onwards, were all eligible for inclusion. The search was restricted to paramedics/paramedic students and learning/maintaining the skill of tracheal intubation. Results: A comprehensive search of CINAHL, MEDLINE and Google Scholar was undertaken. Ten papers were classed as sufficiently relevant for inclusion. They identified that there is no clear definition of a paramedic having ‘learnt’ the skill of intubation. Suggested measures include first-pass success of 90% for pre-hospital intubation, or a range of measures, such as intubation success and complication rates, laryngoscopy technique and decision-making. Intubation training should use a range of modalities, including didactic lectures, videos and practical sessions on multiple types of airway manikins. Supervision by experienced faculty is required. Little is known about how paramedics maintain their skill in intubation, given the lack of clinical opportunity. Yearly skills retraining can help, and can be enhanced by demonstrations/lectures from experienced faculty. Conclusion: Further research is needed to understand how paramedics maintain their skill in intubation, given the limited opportunities to use the skill in a clinical setting and lack of opportunities with UK ambulance services for retraining.
    • PTSD, available support and development of services in the UK Ambulance Service

      Dodd, Greg (2017-06)
      Abstract published with permission. The role of front line ambulance staff in the UK has developed so rapidly that it is almost unrecognisable from days gone by, when scoop and run tactics were commonplace. With additional responsibilities, pressurised decision making and a range of sometimes complex interventions, unique pressures have also developed. The purpose of this article is to review pertinent information relating to how these additional pressures can metamorphose into specific conditions such as post traumatic stress disorder (PTSD). The prevalence of this and other debilitating conditions such as depression and anxiety specific to the ambulance service is reflected upon, whilst existing support from the ambulance service is examined. By broadening both knowledge and confidence relating to this increasingly significant problem, formulation of our own local improvements can take place in the near future.
    • Thinking on scene: using vignettes to assess the accuracy and rationale of paramedic decision making

      Miles, Jamie; Coster, Joanne; Jacques, Richard (2018-04-16)
      Paramedics make important decisions on-scene as to whether a patient requires transport to hospital, referred, or discharged on scene. Research shows that nearly 20% of patients brought to ED by ambulance, could be treated elsewhere. This study aims to investigate the accuracy of conveyance decisions made by on-scene paramedics. https://bmjopen.bmj.com/content/8/Suppl_1/A23.3 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI: 10.1136/bmjopen-2018-EMS.62.