PREHOSPITAL CARE

A review of emergency equipment carried and procedures performed by UK front line paramedics on paediatric patients

K Roberts¹, F Jewkes², H Whalley³, D Hopkins⁴, K Porter⁵

¹ Walsall Manor Hospital, West Midlands, Warwickshire and Northamptonshire Air Ambulance, UK
² Wiltshire Ambulance Service, UK
³ SHO Surgery, Heartlands Hospital, Birmingham, UK
⁴ Warwickshire and Northamptonshire Air Ambulance, UK
⁵ Selly Oak Hospital, Birmingham, UK

Correspondence to:
Correspondence to:
Dr K Roberts
77 Three Acres Lane, Dickens Heath, Solihull, Birmingham B90 1NZ, UK; jkroberts{at}doctors.org.uk

Objectives: In 1997 a review of paramedic practice upon adult patients in the UK found many inconsistencies and deficiencies in basic care. A follow up review in 2002 identified widespread improvement in provision of equipment and skills to provide basic and advanced life support.

Paediatric care was not assessed in either review. The authors conducted this study to identify current standards of care in paediatric paramedic practice and areas of potential improvement.

Method: A questionnaire designed to determine what equipment and skills were available to paramedics for the management of common or serious paediatric emergencies was sent to chief executives of the 32 NHS Ambulance Trusts in England and Wales.

Results: The trend of expanding and standardising practice among adult patients has not extended to paediatric practice despite national guidelines from the Joint Royal Colleges Ambulance Liaison Committee (JRCALC). Furthermore there are some serious failings in the provision of care and skills. Many Trusts have not adopted JRCALC guidelines for the management of life threatening paediatric emergencies such as asthma, meningitis, and fluid replacement in hypovolaemia.

Conclusions: Ambulance Trusts not meeting standards set out in the JRCALC guidelines must address their areas of deficiency. Failure to do so endangers children’s lives and leaves Trusts open to criticism.

Abbreviations: JRCALC, Joint Royal Colleges Ambulance Liaison Committee; LMA, laryngeal mask airway; NPA, nasopharyngeal airways; OPA, oropharyngeal airway

Keywords: paediatric resuscitation; ambulance; paramedic

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