A review of emergency equipment carried and procedures performed by UK front line paramedics
Introduction
Optimal pre-hospital care by the United Kingdom (UK) statutory ambulance services aims to maintain life and alleviate patient morbidity, until definitive care can be delivered in a hospital facility. Simple techniques and equipment are all that are required in order to achieve this, using the well-rehearsed mantra of airway, breathing and circulation. In 1997 in an article published in Pre-hospital Immediate Care [1], it was concluded that basic levels of ambulance equipment were adequate, but that nasopharyngeal airways (NPA), Hudson type oxygen masks, traction splints, long boards and vacuum splints should be more available. It was also suggested that UK paramedics should be able to perform needle cricothyroidotomy and needle thoracocentesis.
This survey aimed to assess the progress made towards the standardisation of equipment and skills by the ambulance services over the last 4 years. The survey was commissioned on behalf of the research and development committee of the Faculty of Pre-Hospital Care at the Royal College of Surgeons in Edinburgh and was timed to coincide with the introduction of a new degree course for ambulance paramedics and the advent of new paramedic protocols by the Joint Royal Colleges and Ambulance Liaison Committee (JRCALC) in the UK.
Section snippets
Method
In June 2001 each of the chief executives of the 31 ambulance services in the UK were sent a postal questionnaire. The questions were designed to determine the equipment carried on front line ambulances for the management of all types of emergencies in children and adults including basic and advanced life support. The questionnaire was structured to follow the standard paradigm of the ‘primary survey’—airway, breathing and circulation with haemorrhage control. It also included specific
Results
Every ambulance service replied to the survey. The results, with comparison to the 1997 results, are presented in Table 1, Table 2, Table 3, Table 4, Table 5.
Discussion
The treatment role of the paramedic is constantly expanding in terms of the procedures that they are able to perform and the equipment needed to carry out these tasks. This study aimed to identify this change by means of review and comparison of their practice over a 4-year period. The original paper identified several areas of inconsistency throughout the country such as the use of airway adjuncts, needle decompression, traction splintage and analgesia. It was felt that the use of inflatable
Conclusion
This paper reports a survey of the equipment carried by and the procedures available to all 31 of the UKs ambulance services in 2001 and compares this data with previous data from 1997. The changes are encouraging although seem slow to happen. The use of a best evidence base and application of current medical trends indicates that ambulance services are adapting to current medical thinking. On the basis of our findings we would recommend the following:
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Universal use of the Hudson type trauma
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