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The ABC of community emergency care
  1. Jim Wardrope1,
  2. Colville Laird2,
  3. Pete Driscoll3
  1. 1Accident and Emergency Department, Northern General Hospital, Sheffield, and South Yorkshire Ambulance Service, UK
  2. 2General Practitioner, Auchterarder, Perthshire, UK
  3. 3Department of Emergency Medicine, Hope Hospital, Manchester, UK
  1. Correspondence to:
 Mr J Wardrope
 Accident and Emergency Department, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK; jimwardropehotmail.com

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1 Introduction, series summary, the system of care

In the UK and in other countries there is a growing shortage of trained clinicians to meet the need for immediate assessment and treatment of urgent medical problems in primary care. Traditionally doctors have been the main providers of this care but already nurses, paramedics, and other healthcare professionals are extending their role to include clinical assessment, decision making, and treatment.12 Our aim is that this series will be a useful update for general practitioners experienced in this field and also serve as an introduction to those new to emergency clinical decision making.

The series will describe the management of non-traumatic emergencies commonly encountered in community emergency care. The objective is to provide a clear and easily followed system of assessment and management of the ill patient.

This system will teach a method for the rapid identification and treatment of immediately life threatening problems or conditions that require urgent hospital care. However, the focus of the series is patients with less serious problems who can be managed without referral to hospital.

The series will use presentations rather than diagnoses as the starting point, for example the approach to the breathless patient rather than the treatment of asthma; the care of the disturbed patient rather than the diagnosis of specific mental illness.

Where possible the series will try to make recommendations based on evidence. The field of emergency medicine is not rich in scientific analysis and community emergency care even less. We will interpret and transfer as much of the evidence as possible into the community emergency care setting.

Lastly and perhaps most importantly, the series sets the immediate management in the context of the start of the patient’s journey. The key principle is—what is right for this patient, in this setting, with my skills, at this time …

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  • Web-only Appendix

    This document is started by Paramedic Practitioners. Where the patient does not need to travel to hospital this is the clinical record. When the patient needs to go to hospital it becomes the clinical record used in hospital.

    Note the areas for recording demographics (page 1), vital signs and social assessment (page 2), clinical notes (page 3 and 4) and for treatment plans (page 4).

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