Journal of Paramedic Practice
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1798
(FIVE YEARS 402)

H-INDEX

9
(FIVE YEARS 3)

Published By Mark Allen Group

2041-9457, 1759-1376

2022 ◽  
Vol 14 (1) ◽  
pp. 6-14
Author(s):  
Rachel Beldon ◽  
Joanne Garside

Background: Staff retention is a significant issue for ambulance services across the globe. Exploratory research, although minimal, indicates that stress and burnout, in particular, influence attrition within the paramedic profession. These need to be understood if their impact on retention is to be addressed. Aims: To determine the presence of and contributory factors for burnout in the ambulance service to inform recommendations for positive change. Methods: A two-phased survey approach was adopted using an adapted Maslach Burnout Inventory and Copenhagen self-assessment burnout questionnaire, to measure levels of burnout, depersonalisation (cynicism) and personal achievement. Open-ended questions explored factors that influenced these. Demographic and comparative analysis identified trends and thematic analysis was carried out on the qualitative data. Results: Ninety-four per cent of ambulance staff in this study (n=382) reported a sense of personal achievement within their professional role; however, more than 50% were experiencing varying levels of burnout with 87% displaying moderate or high levels of depersonalisation towards their work. Causes of stress were complex: themes attributed were a perceived lack of management support, the public's misuse of the ambulance service, involuntary overtime and a poor work-life balance. Conclusions: Burnout poses a genuine threat to retention in the ambulance service and needs addressing. Proactive screening, better communication between practice staff and management and access to counselling services are recommended. This problem of burnout is beginning to be acknowledged but further evidence is needed to understand it in more depth in order for effective solutions to be developed.


2022 ◽  
Vol 14 (1) ◽  
pp. 5-5
Author(s):  
Aysha Mendes

2022 ◽  
Vol 14 (1) ◽  
pp. 26-36
Author(s):  
Anya Critchley

Background: Prehospital traumatic pain is common, but the quality of pain management in these patients is poor. Current practice recommends morphine as the first-line analgesia in major trauma but this carries high risks and is often contraindicated. Alternative paramedic-administered analgesia does not provide adequate pain relief or may be contraindicated. As a result, many patients remain in pain. Analgesic ketamine is used safely and effectively in international civilian and military settings and by paramedics with additional training, education and qualifications. Aim: The study had two aims. Namely, these were to find out whether intravenous ketamine: provides effective relief of prehospital traumatic pain in adults; and is safe for prehospital administration by non-specialist paramedics. Method: Three databases, CINAHL, MEDLINE and AMED, were searched to identify articles published between 2009 and 2021. Exclusion criteria were applied and results subjected to critical appraisal and evaluation. Findings: Four studies were included in the review. Two themes were identified for thematic analysis: therapeutic effectiveness; and the safety of IV ketamine administration by paramedics. The evidence drew predominantly homogenous conclusions, but was substandard regarding external validity, which limited the quality of these conclusions. Conclusion: Ketamine provides effective pain relief in line with morphine and is safe for paramedics to administer. However, clear gaps in the evidence mean the research questions are not fully answered, so changes to current paramedic practice cannot be recommended.


2022 ◽  
Vol 14 (1) ◽  
pp. 38-38
Author(s):  
Barry Costello

‘Five hundred twenty five thousand six hundred minutes, how do you measure a year in the life?’ - Seasons of Love, Jonathan Larson


2022 ◽  
Vol 14 (1) ◽  
pp. 39-39
Author(s):  
Terri Misselbrook ◽  
Pete Gregory

2022 ◽  
Vol 14 (1) ◽  
pp. 16-24
Author(s):  
Sonja J Maria ◽  
Peter S Micalos ◽  
Lauren Ahern

Chest pain is a common medical symptom that paramedics attend to in the out-of-hospital environment. The causes of chest pain and the signs and symptoms are explained in this article, alongside tools that could be useful in diagnosis, such as clinical risk scores and troponin testing. Finally, pain management strategies that use a balanced approach for optimal patient care are referred to, with some specificity for cardiac chest pain explained.


2021 ◽  
Vol 13 (12) ◽  
pp. 514-522
Author(s):  
Julien Devergie ◽  
Andrew O'Regan ◽  
Peter Hayes

Background: Internationally, the paramedic scope of practice is developing. Bypassing emergency departments in favour of direct access to primary percutaneous coronary intervention laboratories has been limited largely to cases of ST-elevation myocardial infarction and new-onset left bundle branch block, but updates to international guidelines suggest that enhancing paramedics' skills in interpreting electrocardiograms (ECGs) and widening the bypass criteria could be beneficial. Aim: The aim of the study is to explore paramedics' views on ways to improve their ECG interpretation abilities. Method: A two-arm design was used with an online questionnaire (quantitative) and one-to-one interviews (qualitative). The questionnaire results were used to inform the interview guide. Findings: One hundred and eighteen paramedics completed the survey, and 11 took part in interviews. The major themes identified from the template analysis of the interviews were ‘a profession in transition’, ‘lagging professional development’ and ‘supporting the frontline’. Self-directed learning resources before, during and after action were proposed. Conclusion: Paramedicine is evolving in Ireland and practitioners have reported undertaking self-directed learning activities. The resulting heterogeneity in skills such as ECG interpretation, and perceived barriers to education, can cause feelings of vulnerability within the profession. Supporting the frontline by introducing some Group-Orchestrated Self-Directed Learning resources could empower practitioners and contribute to the evolution of prehospital care in Ireland.


2021 ◽  
Vol 13 (12) ◽  
pp. 526-526
Author(s):  
Jolyon Price

2021 ◽  
Vol 13 (12) ◽  
pp. 492-492
Author(s):  
Sian Cowell
Keyword(s):  

In our last segment of Paramedic Roles, Sian Cowell shares her journey towards public health after a COVID-19 infection and subsequent redeployment catapulted her in this unconventional but exciting direction


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