Now showing items 1-20 of 1264

    • Annual SHOT Report 2020

      Bellamy, Mark; Narayan, Shruthi; Spinks, Courtney; Davies, Jennifer; Poles, Debbi; Milser, Emma; Carter-Graham, Simon; Tuckley, Victoria; Flannagan, Joe; Yawitch, Tali
      Transfusion delays, particularly in major haemorrhage and major trauma situations, must be prevented. Delays in provision and administration of blood components including delays in anticoagulant reversal, particularly in patients with intracranial haemorrhage, can result in death, or serious sequelae. Every minute counts in these situations. Effective and reliable transfusion information technology systems should be implemented to reduce the risk of errors at all steps in the transfusion pathway, provided they are configured and used correctly. Effective investigation of all incidents and near miss events, application of effective corrective and preventive actions, and closing the loop by measuring the effectiveness of interventions should be carried out to optimise learning from incidents Taken from Key recommendations from summary: Full text available at:
    • Exploring variation in ambulance calls and conveyance rates for adults with diabetes mellitus who contact the Northern Ireland Ambulance Service: a retrospective database analysis

      Watson, Aoife; Clubbs Coldron, Benjamin; Wingfield, Benjamin; Ruddell, Nigel; Clarke, Chris; Masterson, Siobhan; McConnell, Donna; Coates, Vivien (2021-12)
      People with diabetes frequently contact the ambulance service about acute problems. Overall, treating diabetes and its associated complications costs the NHS 10% of the annual budget. Reducing unnecessary hospital admissions and ambulance attendances is a high priority policy for the NHS across the UK. This study aimed to determine the characteristics of emergency calls for people with diabetes who contact the ambulance service and are subsequently conveyed to hospital by the Northern Ireland Ambulance Service (NIAS). Abstract published with permission.
    • Diversity in practice

      Costello, Barry (2022-03)
      I have never been one for ignoring the ‘pink elephant in the room’, and with just under 8 months remaining, my time as a newly qualified paramedic (NQP)—that 2-year period of consolidated learning—is drawing ever closer to its end, and with that I can't help but wonder…what's next? Abstract published with permission.
    • Becoming yourself

      Costello, Barry (2021-12-02)
      ‘The thing that is really hard, and really amazing, is giving up on being perfect and beginning the work of becoming yourself’ - Anna Quindlen Abstract published with permission.
    • Taking meaningful steps

      Costello, Barry (2022-01-02)
      As the clock strikes 12 and we collectively say goodbye (or good riddance) to 2021, I find myself singing this beautiful song over in my head while reminiscing on the year since passed—my first as a newly qualified paramedic (NQP), my first year of ‘experience’. I always reassured myself that with experience would come enlightenment, although I never fully understood exactly how to measure it, or what form it would take when it did arrive…a beaming ray of light from the sky possibly? Abstract published with permission.
    • A dystopian new normal

      Costello, Barry (2021-09-02)
      Looking back on his unconventional start in paramedicine, Barry Costello reflects on how to not only survive, but to thrive, as a paramedic despite the challenges of today's ‘new normal’ Abstract published with permission.
    • Every day a school day

      Costello, Barry (2021-07-02)
      Nearly a year into his career as an NQP, Barry Costello reflects on why a patient-centred approach to care matters and how it will impact him as an ongoing learner in paramedicine. Abstract published with permission.
    • Benefits of joining the Emergency Planning Society

      McClure, Jeff (2011-05)
      The Emergency Planning Society was formed in 1993 through the merger of the Emergency Planning Association and the County Emergency Planning Officers Society. The society, its branches and its various groups organize conferences, workshops, working parties, studies and seminars to examine emergency planning practice and experience, and to develop advice on good practice. Here, Jeff McClure, Assistant Emergency Planning Manager with Northern Ireland Ambulance Service, discusses the society in more depth, and examines the role of paramedics in the society's structure. Abstract published with permission.
    • A Multi-disciplinary approach to falls prevention in the elderly

      Leggett, Chris; Jess, Julie; McNamara, Ruth (2017-10-17)
    • The fear of losing a child!

      Skehin, K.; Molloy, S.; McGrath, A.; Bourke, T.; Flannigan, C. (2020-10-25)
    • Prehospital care in isolated neck of femur fracture: a literature review

      O'Connor, Rory (2019-01-02)
      Around 65 000 people experience a fractured neck of femur (NOF) each year in the UK. It is estimated that one in 10 patients with an NOF fracture will die within 1 month, and one in three will die within 1 year. The bill for NOF fracture, excluding substantial social care costs, is £1 billion per year. Given the exposure that ambulance services have to these patients, several aspects of NOF fracture care could be improved in the prehospital environment, which could also generate significant savings for the NHS. This article reviews the literature regarding NOF fracture care, and highlights aspects that affect ambulance services and prehospital care. A variety of these, including pain management, fast-track systems, fluid therapy and renal impairments, can be improved, but evidence specific to the prehospital environment is lacking. Abstract published with permission.
    • Complications associated with pre-hospital open thoracostomies: a rapid review

      Mohrsen, Stian; McMahon, Niall; Corfield, Alasdair; Mckee, Sinead (2021-12-04)
    • Celebrating International Women's Day: where does this leave the paramedic profession?

      Wilson, Caitlin; Prothero, Larissa Stella; Williams, Julia (The College of Paramedics, 2022-03)
    • An atypical presentation of orthostatic hypotension and falls in an older adult

      Thoburn, Steve; Cremin, Steve; Holland, Mark (The College of Paramedics, 2022-03)
      Introduction: Falls are a significant cause of morbidity and mortality in older adults. Orthostatic hypotension (OH) is very common in this cohort of patients and is a significant risk for falls and associated injuries. We present the case of an 89-year-old female who fell at home, witnessed by her husband. OH was identified during the clinical assessment and considered to be the predominant contributing factor, although the clinical presentation was not associated with classical symptoms. Case presentation: The patient lost balance while turning away from the kitchen sink; she noted some instability due to a complaint of generalised weakness in both of her legs. No acute medical illness or traumatic injury was identified. A comprehensive history was obtained that identified multiple intrinsic and extrinsic risk factors for falling. The cardiovascular examination was unremarkable except for OH, with a pronounced reduction in systolic blood pressure of 34 mmHg at the three-minute interval and which reproduced some generalised weaknesses in the patient's legs and slight instability. Although classical OH symptoms were not identified, this was considered to be the predominant factor contributing to the fall. A series of recommendations was made to primary and community-based care teams based upon a rapid holistic review; this included a recommendation to review the patient's dual antihypertensive therapy. Conclusion: It is widely known that OH is a significant risk factor for falls, but asymptomatic or atypical presentations can make diagnosis challenging. Using the correct technique to measure a lying and standing blood pressure, as defined by the Royal College of Physicians, is crucial for accurate diagnosis and subsequent management. Ambulance clinicians are ideally placed to undertake this quick and non-invasive assessment to identify OH in patients that have fallen. Abstract published with permission.
    • A survey of ambulance clinicians’ perceptions of recording and communicating patient information electronically

      Barrett, Jack; Eaton-Williams, Peter; Mortimer, Craig; Land, Victoria; Williams, Julia (2021-06-01)
      Objective: Ambulance services are evolving from use of paper-based recording of patient information to electronic platforms and the impact of this change has yet to be fully explored. The aim of this study is to explore how the introduction of a system permitting electronic information capture and its subsequent sharing were perceived by the ambulance clinicians using it. Methods: An online questionnaire was designed based upon the technology acceptance model and distributed throughout one ambulance service in the south east of England. Closed-ended questions with Likert scales were used to collect data from patient-facing staff who use an online community falls and diabetic referral platform or an electronic messaging system to update GPs following a patient encounter. Results: There were 273 responses from ambulance clinicians. Most participants agreed that they used tablet computers and smartphones to make their life easier (85% and 86%, respectively). Most participants felt that referring patients to a community falls or diabetic team electronically was an efficient use of their time (81% and 81%, respectively) and many believed that these systems improved the communication of confidential patient information. GP summaries were perceived as increasing time spent on scene but most participants (89%) believed they enabled collaborative working. Overall, collecting and sharing patient information electronically was perceived by most participants as beneficial to their practice. Conclusion: In this study, the ability to electronically refer patients to community services and share patient encounters with the GP was predominantly perceived as both safe for patients and an effective use of the participants’ clinical time. However, there is often still a need to communicate to GPs in real time, demonstrating that technology could complement, rather than replace, how clinicians communicate. Abstract published with permission.
    • In a simulated adult trauma patient, can pelvic binders be applied accurately by paramedics and HEMS paramedics? A pilot observational study

      McCreesh, Samuel (2021-05-01)
      Pre-hospital treatment of suspected haemorrhagic pelvic fractures includes application of a purpose-made pelvic binder. Recent hospital studies identified poor accuracy of pelvic binder application, but there is little pre-hospital research to date. Abstract published with permission.
    • To collar or not to collar. Views of pre-hospital emergency care providers on immobilisation without cervical collars: a focus group study

      Thompson, Lee; Shaw, Gary; Bates, Charlotte; Hawkins, Christopher; McClelland, Graham; McMeekin, Peter (2021-05-01)
      Spinal cord injury (SCI) is a rare event, with high numbers of patients unnecessarily immobilised with no potential benefit based on limited evidence from the 1950s and 1960s. Contemporary opinion now challenges the notion that traditional immobilisation prevents movement and protects the spine. Current literature suggests that these methods which include semi-rigid collars can potentially cause more movement of the spine and harm the patient. The purpose of this study was to explore the views and perspectives of pre-hospital care providers on immobilising patients without the use of a semi-rigid collar. 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. DOI Abstract published with permission.
    • Paramedic independent prescribing: a qualitative study of early adopters in the UK

      Stenner, Karen; Van Even, Suzanne; Collen, Andy (2021-05-01)
      Paramedics working in advanced practice roles in the UK can now train to prescribe medicine. This is anticipated to benefit patient access to medicines and quality of care where there is a national shortage of doctors, particularly in primary care. Abstract published with permission.
    • A paramedic's role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review

      Bonner, Mhairi; Capsey, Matt; Batey, Jo (2021-05-01)
      Background: Around 10–25% of emergency calls for adults aged over 65 are attributed to falls. Regardless of whether injuries are caused, quality of life is often affected by fear of falling, leading to reduced confidence and activity, negatively impacting mobility and risking depression and isolation. Ambulance service staff are well placed to identify falls risk factors so patients can be directed to falls prevention services. This article aims to determine how the referral by paramedics of uninjured falls patients to community falls services may reduce future falls and emergency services use. DOI Abstract published with permission