Background:
Ambulance Services across Australia and the world have clinical practice guidelines or protocols which
outline the treatment and management of specific patient presentations. These guidelines vary greatly in
everything from how they look, to what they include and the treatment they describe. Some ambulance
services have guidelines which are well-defined and easier to follow and understand than others. Some
include a lot of detail and background information, whereas others simply list treatment options. Also, the
management of certain patient conditions may be clearer when expressed in a specific layout (e.g. flowchart
or diagrams).
Whilst there is great variance in the format and detail in guidelines across different ambulance services,
each organisation no doubt would defend their documents as being current best practice and the correct
way things should be done! The one thing that is in common between most ambulance service guidelines
however, is the lack of evidence justifying the content. Usually there are no references supporting the
subject matter at all. So are they really based on current best practice?
Assessment:
Your task is to design a clinical practice guideline/treatment pathway for a specific condition which has
been allocated to you. You must decide on the layout and format which best suits the condition, and
describe the paramedic management in an out-of-hospital context.
You will need to research the condition, to find out what is the current best practice, and provide
references which support the treatment you describe. You may review guidelines which already exist for
the condition you have been allocated, but these should not be copied or dictate the management you
explain (use journal articles instead).
You have free-range over the design of your guideline, but consider it should be 2-3 pages in length.
Include some background information on the condition and issues for paramedics to reflect on. Highlight
potential ‘time-critical’ situations and difficulties with patient assessment. You may also want to consider
some overall patient safety statements such as “all unconscious patients should be transported to hospital
regardless of the cause” etc.
The guideline should also include explicit details around drugs to administer, including the dose and how
often. You may suggest the use of drugs which are currently not common place in the prehospital setting,
provided there is evidence supporting their use and it would be reasonable to carry these drugs in an
ambulance (e.g. does not require a fridge). There is no need to segregate different levels of practitioner
(e.g. Intensive Care Paramedic) – your guideline would be used by every paramedic regardless of their
skills.
Questions:
Use the dedicated assignment forum on FLO if you have any questions regarding this assessment