1. Clinical Practice Guidelines for use by UK Ambulance Services
JRCALC
Clinical Practice Guidelines
for use by UK Ambulance Services

2. Why?

3. Common standards of care
NW1 4LE
Panarama
Political
Common standards of care
CHI
Panarama – Monday 17 January 2000

4. Pre-Hospital Clinical Guidelines
Version 1
October 2000

5. JRCALC Guidelines sub-committee
50 members
Ambulance Medical Directors
Training Officers
Others

6. Development Feedback from Trusts Warwick University Consensus view
Established National Guidelines
Version

8. Local vs. National Guidelines
LAPSC
Training
Resources
Funding
PGDs
IHCD Training manuals
Paramedic Registration
CHI

9. June 2004 Evidence base Reformatting User-friendly BestBets A4
Pocket books

11. What’s changed Consent chapter revised Professional Standards - HPC
IV fluids – 250ml boluses
NW Oxygen Guidelines
Obs. & Gynae
Mental Health – future risk table
Burns consensus guidance

12. What’s changed ROLE Start BLS whilst establish circumstances
May then stop if ROLE criteria fulfilled
Includes DNAR directives
Extended to Children
No need for doctor to confirm death

13. What’s changed Morphine Diazepam for Cocaine overdose
Maximum dose 20mg
Paediatric doses
Diazepam for Cocaine overdose
Atropine in children only for bradycardia from vagal stimulation
Aspirin GU/DU caution only

14. What’s changed Thrombolytics Pain lasting at least 15 mins
Onset less than 6 hours ago
Diastolic less than 110mmHg
RBBB permitted (must also have ST elevation)
CPR not a contra-indication

15. What’s New Sickle Cell crisis Hyperventilation Child Protection
Dealing with death of a child
CBRN
Ipratropium

16. Drug Codes Pre-Hospital Emergency Care Department of Health
Airport Codes
Full name as well
Department of Health
National Patient Safety Agency

17. FUROSEMIDE
FRM
GLUCOSE GEL
GLG
GLUCOSE 50%
GLL
GLUCOSE 50% (Latin suffix 'L' used to indicate '50'%)
GLUCAGON
GLU
GLUCOSE 10%
GLX
GLUCOSE 10% (Latin suffix 'X' used to indicate '10'%)
GLYCERYL TRINITRATE (GTN)
GTN
GLYCERYL TRINITRATE
HEPARIN (STANDARD UNFRACTIONATED)
HEP
HEPARIN

18. Clinical Performance Indicators (CPI)
ASA Clinical Effectiveness Dept.
10th December 2003
Benchmarking
Voluntary/Compulsory
Outcome measures

19. The Future 2006 Evidence based review of all guidelines
Hyperlinks to Evidence
All Guidelines Group may comment
Secure Web-based development site