J T Gray1, J Wardrope. 1. Yorkshire Ambulance Service (South), Fairfields, Moorgate Road, Rotherham, S60 2BQ, UK. james.gray@yas.nhs.uk
Abstract
BACKGROUND: Recent government policy has looked at improving the role of ambulance services in delivering alternative care models for patients. OBJECTIVE: To review the outcomes of the introduction of some specific non-transport guidelines into an ambulance service. METHODS: A retrospective review was undertaken of the documentation produced from the use of these protocols in the first 4 months following introduction for appropriateness of use, and potential for risk of adverse outcome. RESULTS: Of 354 uses of the guidelines, 140 (39.5%) were considered inappropriate. A large number of these were cases where the issue was refusal of transport rather than a use of the guideline. Of the rest the more focused guidelines showed better adherence (hypoglycaemia 2/69 inappropriate, epilepsy 1/23 inappropriate) than the more non-specific guidelines (no apparent injury 17/84 inappropriate, minor limb injury 28/58 inappropriate). CONCLUSIONS: This short study suggests that focused guidelines can help support ambulance staff decision making; however, care must be taken to ensure safe practice and that these guidelines are not used to add legitimacy to poor practice.
BACKGROUND: Recent government policy has looked at improving the role of ambulance services in delivering alternative care models for patients. OBJECTIVE: To review the outcomes of the introduction of some specific non-transport guidelines into an ambulance service. METHODS: A retrospective review was undertaken of the documentation produced from the use of these protocols in the first 4 months following introduction for appropriateness of use, and potential for risk of adverse outcome. RESULTS: Of 354 uses of the guidelines, 140 (39.5%) were considered inappropriate. A large number of these were cases where the issue was refusal of transport rather than a use of the guideline. Of the rest the more focused guidelines showed better adherence (hypoglycaemia 2/69 inappropriate, epilepsy 1/23 inappropriate) than the more non-specific guidelines (no apparent injury 17/84 inappropriate, minor limb injury 28/58 inappropriate). CONCLUSIONS: This short study suggests that focused guidelines can help support ambulance staff decision making; however, care must be taken to ensure safe practice and that these guidelines are not used to add legitimacy to poor practice.
Authors: Salvatore Silvestri; Steven G Rothrock; Dan Kennedy; Jay Ladde; Marsha Bryant; Joseph Pagane Journal: Prehosp Emerg Care Date: 2002 Oct-Dec Impact factor: 3.077
Authors: Deborah Shaw; Jane V Dyas; Jo Middlemass; Anne Spaight; Maureen Briggs; Sarah Christopher; A Niroshan Siriwardena Journal: BMC Emerg Med Date: 2006-09-19
Authors: A Khorram-Manesh; K Lennquist Montán; A Hedelin; M Kihlgren; P Örtenwall Journal: Eur J Trauma Emerg Surg Date: 2010-05-04 Impact factor: 3.693
Authors: Wim Breeman; Nathan A Poublon; Michael H J Verhofstad; Esther M M Van Lieshout Journal: Scand J Trauma Resusc Emerg Med Date: 2018-09-14 Impact factor: 2.953
Authors: Kari Heinonen; Tuukka Puolakka; Heli Salmi; James Boyd; Mia Laiho; Kari Porthan; Heini Harve-Rytsälä; Markku Kuisma Journal: Acta Anaesthesiol Scand Date: 2022-02-28 Impact factor: 2.274
Authors: Alexander Olaussen; William Semple; Alaa Oteir; Paula Todd; Brett Williams Journal: BMC Med Inform Decis Mak Date: 2017-10-11 Impact factor: 2.796