UK Paramedic working standards

[island emt]

point :::: SET ::::: & Match to the Brit in the corner.

KIWI goes down in flames again

[hertzvanrental]

co - amoxiclav for open fractures, procedural sedation etc etc for some advanced paras

London trialing adenosine in NCT AND leaving the patient at home!

NG/OG tube insertion.

Access to social services/district nurses/midwives/ECP,PP/GP surgeries etc therefore reducing the need to take every one in.

Clopidogrel/ticagrelor pre ppci

Low dose aspirin course & referral to a TIA clinic negating the need to transport every TIA that has fully recovered

Ring magnets in the treatment of ICD firing

Autopulse, lucas which we had years ago, now making a comeback.

Critical haemorrhage management. Inc CAT & pelvic Sam splints which we've had for years.

I could carry on

co - amoxiclav for open fractures, procedural sedation etc etc for some advanced paras

London trialing adenosine in NCT AND leaving the patient at home!

NG/OG tube insertion.

Access to social services/district nurses/midwives/ECP,PP/GP surgeries etc therefore reducing the need to take every one in.

Clopidogrel/ticagrelor pre ppci

Low dose aspirin course & referral to a TIA clinic negating the need to transport every TIA that has fully recovered

Ring magnets in the treatment of ICD firing

Autopulse, lucas which we had years ago, now making a comeback.

Critical haemorrhage management. Inc CAT & pelvic Sam splints which we've had for years.

I could carry on

[craig]

Prehopistal thrombolisis

Adrenaline bolus' for compromised pt unresponsive to atropine

And considering the vast majority of 911/000/999/112 calls aren't life or death who else has practitioners who can suture/glue wounds, treat with a whole host of antibiotics, steroids, analgesics and refer to specific wards or back to community services

PARACETAMOL which is a brilliant analgesic (we've had that for 3 years).

We also treat and refer patients all the time and have done for years.

All the above is being done by the NSW ambulance service. In fact they received ans international recognition for their LAPP /ECP program ant they have as

Also received awards fro the implementation of pre-hospital thrombosis treatment of cardiac/ stroke patients

[mattias]

Hello UK-paramedics,

the discussion kind of caught my interest. As you all probably know we've got quite a different system in Germany (based on an emregency physician on scene in any (potentially) life threatening emergency) and as a secondary school English teacher I've recently become more and more interested in the UK system. Having studied the

UK Ambulance Service Clinical Practice Guidelines I was wondering a bit as I thought the UK paramedics to have slightly more possibilities, the already mentioned cardioversion only one of them.

Hertzvanrental has already made his point clear on this one, even though I do think an untreated tachycardia causing angina-symptons does possibly cause damage to the heart muscle and thus may have a negative effect on the patients outcome. But furthermore I would like to know how the UK paramedic deals with the following.

1. Hypertensive emergency (There was no drug in the guidelines except from GTN in case of angina symtpoms)

2. Nausea and vomiting (prevention) for children (as the use of Metoclopramid is not advised for these patients)

3. Sedation of anxious patients/in severe cases of acute mental disorder/of intubated patients after a successful resuscitation.

I think everything else is covered quite well by the guidelines but I believe the mentioned cases might cause a slight discomfort, on the patient’s as well as on the paramedic’s side. Are they covered by regional guidelines?

In Germany (only speaking of the region I’m living in) the usual treatments (by the emergency physician) would be

1. Urapidil

2. Dimenhydrinate (also used for adults because of much lesser side effects than MCP)

3. Diazepam/Midazolam (in case of intubated patients combined with Fentanyl and muscle relaxants but again, adminstered by an emergency physician)

Hope for a reply, and please don’t take anything of it as criticism, I’m no militant anglo-american vs. German-franco fighter. J

[scott33]

Sorry mate, those guidelines are out of date. The UK ambulance service are using this now...

http://aaceguidelines.co.uk/

[BushyFromOz]

All the above is being done by the NSW ambulance service. In fact they received ans international recognition for their LAPP /ECP program ant they have as

Also received awards fro the implementation of pre-hospital thrombosis treatment of cardiac/ stroke patients

you guys are thrombolysing CVA's in he field??

[craig]

you guys are thrombolysing CVA's in he field??

Not cva's. Bit hard with out the aid of a CT to rule out heamorragic causes

We are doing the FAST protocol to go directly (allowing us to bypass at our discretion) to a centre that can CT and thrombolyse for strokes

But we are doing thrombolytics on AMI's

Edited May 24, 2013 by craig

[BushyFromOz]

Any chance i could get a copy of your 3P's craig?

[craig]

Any chance i could get a copy of your 3P's craig?

You should be able to to go the web site and they should be there to down load bushy.........just been informed that the update is being released in the next couple of weeks

[mattias]

Sorry mate, those guidelines are out of date. The UK ambulance service are using this now...

http://aaceguidelines.co.uk/

Hi Scott,

got them today, question 1+3 stay the same (Hypertensive Emergency not even mentioned).

Can you help me out? Are you driving emergency ambulances? What would your paramedic do?

Thx