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    Is paramedic practice ready to adopt the NICE Transient Loss of Consciousness Guideline?

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    Author
    Thoburn, Steve
    Keyword
    Emergency Medical Services
    Auscultation
    Electrocardiogram (ECG)
    Diagnostic Techniques and Procedures
    Unconsciousness
    Clinical Protocols
    Journal title
    Journal of Paramedic Practice
    
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    URI
    http://hdl.handle.net/20.500.12417/589
    DOI
    10.12968/jpar.2013.5.10.568
    Abstract
    Abstract published with permission. In 2010 the National Institute for Health and Care Excellence (NICE) published a guideline to assist clinicians, across various healthcare settings, to diagnose and subsequently manage patients experiencing a transient loss of consciousness (TLoC). The guideline emphasises that patients who are diagnosed as having had an ‘uncomplicated faint’ or ‘situational syncope’, from the initial assessment process, may not require conveyance to the nearest emergency department. JRCALC have included these recommendations within the latest published guidelines. Evidently, this may reduce inappropriate admissions and reduce unnecessary NHS expenditure. In addition it enables clinicians to provide care to patients within their home environment thus improving their experience and outcome as a service user. Furthermore, non-conveyance may reduce ambulance turn-around times enabling clinicians to become available to respond to life-threatening emergencies sooner. However, to utilise the guideline, clinicians are expected to be proficient in aspects of history taking, physical examination and 12-lead ECG interpretation. The current paucity of pre-hospital evidence base provides no support for use of the guideline by paramedics. It is questionable as to whether further education and training are required, before paramedics can utilise the guideline, to diagnose and discharge patients at scene without causing any detriment to patient outcome.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2013.5.10.568
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