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Journal of Paramedic Practice最新文献

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On the page 在页面上
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.181
Aysha Mendes
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引用次数: 0
Ethical dilemmas: a student reflection on safeguarding in adult domestic abuse 伦理困境:学生对成人家庭虐待防护的反思
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.183
Will Hird
This reflective account discusses a case where a patient refused a safeguarding referral after disclosing domestic abuse to a student paramedic on an MSc programme. The author examines the medical, ethical and legal evidence when determining whether the right path was taken in caring for this patient. It is argued that the care delivered was lawful and ethical but the student paramedic did not have sufficient awareness of the support options available to those experiencing domestic abuse. Their oversimplification of the dilemma to the patient having capacity to refuse referral omitted key aspects of the medico-legal framework, potentially to the detriment of the patient's care. Reflective learning has allowed the author to recognise the limits of his understanding of the complex medico-ethico-legal framework surrounding domestic abuse, consent, coercion and controlling behaviour. In response, he has established a new methodology to assess the underlying reasons for refusing a safeguarding referral.
这篇反思性文章讨论了一个病例,患者在向一名攻读理学硕士课程的辅助医务人员学生披露家庭虐待行为后,拒绝接受保障转介。作者在判定护理该患者是否正确时,对医疗、伦理和法律证据进行了研究。作者认为,所提供的护理是合法和合乎道德的,但该学生辅助医务人员对遭受家庭虐待者可选择的支持方案缺乏足够的认识。他们将困境过度简化为病人有能力拒绝转诊,忽略了医疗法律框架的关键方面,可能会对病人的护理造成损害。通过反思学习,作者认识到自己对围绕家庭虐待、同意、胁迫和控制行为的复杂医学-伦理-法律框架的理解存在局限性。为此,他建立了一种新的方法来评估拒绝保障转介的根本原因。
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引用次数: 0
Prehospital management of sepsis with IV antibiotics: a UK literature review 院前使用静脉注射抗生素治疗败血症:英国文献综述
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.194
Patryk Jadzinski, Sarah Fouch, Chris Markham, Rebecca Stores
Sepsis mortality rates increase if prompt treatment is not administered. The Sepsis Six care bundle advocates the early administration of broad-spectrum intravenous antibiotics to reduce mortality and morbidity but this is not routinely practised nationally in UK prehospital settings, although UK ambulance services regularly attend septic patients. A literature review was conducted to investigate knowledge around paramedics' ability to recognise and treat prehospital sepsis with intravenous antibiotics in the UK and the impact of this on patient outcomes. A search was conducted and the three eligible studies included underwent a structured critical appraisal and thematic analysis. Three themes emerged: diagnostic accuracy; administration of prehospital antibiotics; and impact on patient outcomes. There is a significant gap in evidence in this field in the UK, and it was difficult to make generalised recommendations from the studies. Paramedics have the potential to be highly accurate in the recognition of sepsis and administer intravenous antibiotics when following a protocol. No major studies measure patient outcomes following prehospital intravenous antibiotics administration by paramedics in the UK and large empirical studies should be conducted to assess the effectiveness of this.
如果不及时治疗,败血症的死亡率会增加。脓毒症六项护理捆绑计划提倡尽早使用广谱静脉注射抗生素来降低死亡率和发病率,但在英国院前环境中,尽管英国救护车服务机构会定期接诊脓毒症患者,但这一做法并未在全国范围内常规实施。我们进行了一项文献综述,以了解英国医护人员识别院前败血症并使用静脉注射抗生素进行治疗的能力,以及这对患者预后的影响。我们进行了检索,并对符合条件的三项研究进行了结构化批判性评估和主题分析。结果发现了三个主题:诊断准确性;院前抗生素的应用;对患者预后的影响。英国在这一领域的证据存在很大差距,因此很难从这些研究中提出概括性建议。辅助医务人员有可能高度准确地识别败血症,并按照方案静脉注射抗生素。在英国,还没有大型研究对辅助医务人员在院前静脉注射抗生素后的患者治疗效果进行评估,因此应开展大型实证研究来评估其有效性。
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引用次数: 0
Peaks and troughs 波峰和波谷
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.215
D. Wyatt
After experiencing one of the most difficult losses and continuing to navigate the journey of grief, Dan Wyatt reflects on the peaks and troughs of life, the support that is out there during the low points, and the surprisingly therapeutic nature of putting it all down on the page
丹-怀亚特经历了最艰难的一次丧亲之痛,并在悲痛中继续前行,他回顾了人生的高峰和低谷、低谷中的支持,以及将一切写在纸上的惊人疗效
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引用次数: 0
Decision making in prehospital and paramedic practice: part 1 院前和辅助医疗实践中的决策:第一部分
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.cpd1
L. Sibson
This first continuing professional development article in this 2-part series on decision-making explores this process in prehospital and paramedic practice and the complex world of how clinicians make decisions in often challenging and time-critical situations in prehospital settings. It gives a brief overview of the neuroanatomy involved in decision-making, problem-solving and critical thinking as well as Bloom's taxonomy and its application to prehospital practice. While it is outside the remit of this paper to incorporate all theories regarding decision-making, it will explore some key concepts and frameworks around it.
这是关于决策的两部分系列文章中的第一篇继续职业发展文章,探讨了院前和辅助医疗实践中的决策过程,以及临床医生如何在院前环境中通常具有挑战性且时间紧迫的情况下做出决策的复杂世界。它简要概述了决策、解决问题和批判性思维所涉及的神经解剖学,以及布鲁姆分类法及其在院前实践中的应用。虽然纳入所有有关决策的理论不属于本文的研究范围,但本文将探讨有关决策的一些关键概念和框架。
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引用次数: 0
Never struggle alone 永远不要独自奋斗
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.216
Katy Sofield
Katy Sofield reflects on a job that would overwhelm even the most experienced paramedic
凯蒂-索菲尔德(Katy Sofield)回顾了一项即使是最有经验的辅助医务人员也会不知所措的工作
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引用次数: 0
Guidelines for peer reviewers 同行评审员指南
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.212
Have you ever considered becoming a peer reviewer? In this issue, we provide the Journal of Paramedic Practice guidelines for peer reviewers. Have a read and contact the editor with your CV if you think you want to join the JPP peer reviewer panel
您是否考虑过成为同行评审员?本期,我们将提供《辅助医疗实践期刊》同行评审员指南。如果您认为自己想加入《护理实践期刊》同行评审小组,请阅读并与编辑联系,提供您的简历。
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引用次数: 7
ECG case series for paramedics: May 2024 辅助医务人员心电图病例系列:2024 年 5 月
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.182
Charles Bloe
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引用次数: 0
Paramedic role in emergency mental healthcare 辅助医务人员在紧急心理保健中的作用
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.204
Joel Simon Phillips
Paramedics are increasingly involved in providing emergency mental healthcare through specialist mental health paramedic roles or expanded responsibilities within generalist roles. This article reviews the relevant academic literature to critically evaluate the opportunities and challenges of greater paramedic involvement in mental health. Potential benefits include prompt crisis response, improved service integration, and enhanced accessibility. However, challenges exist around limited mental health training, role ambiguity, care continuity, and stakeholder concerns. Realising the benefits of paramedics in mental healthcare requires investment in education, clear protocols, strong governance, and collaboration with mental health professionals and service users to ensure safety and quality.
越来越多的辅助医务人员通过专业的心理健康辅助医务人员角色或扩大的普通医务人员角色职责,参与提供紧急心理保健服务。本文回顾了相关的学术文献,批判性地评估了辅助医务人员更多地参与心理健康工作所带来的机遇和挑战。潜在的益处包括迅速的危机响应、改善服务整合以及提高可及性。然而,在有限的心理健康培训、角色模糊性、护理连续性以及利益相关者的担忧等方面也存在挑战。要实现辅助医务人员在精神卫生保健中的益处,就需要在教育、明确的协议、强有力的管理以及与精神卫生专业人员和服务使用者的合作方面进行投资,以确保安全和质量。
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引用次数: 0
A need for national oversight in ambulance AI integration 救护车人工智能整合需要国家监督
Pub Date : 2024-05-02 DOI: 10.12968/jpar.2024.16.5.190
Joe Frankland
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引用次数: 0
期刊
Journal of Paramedic Practice
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