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Transcript
JRCALC
Clinical Practice
Guidelines
for use by UK Ambulance Services
June 2004
• Evidence base
– BestBets
• Reformatting
• User-friendly
– A4
– Pocket books
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
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
What’s changed
• Morphine
– Maximum dose 20mg
– Paediatric doses
• Diazepam for Cocaine overdose
• Atropine in children only for
bradycardia from vagal stimulation
• Aspirin GU/DU caution only
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
What’s New
• Sickle Cell crisis
• Hyperventilation
• Child Protection
• Dealing with death of a child
• CBRN
• Ipratropium
Drug Codes
• Department of Health
• National Patient
Safety Agency
• Pre-Hospital
•
•
Emergency Care
Airport Codes
Full name as well
FUROSEMIDE
FRM
FUROSEMIDE
GLUCOSE GEL
GLG
GLUCOSE GEL
GLUCOSE 50%
GLL
GLUCOSE 50% (Latin suffix 'L' used to indicate '50'%)
GLUCAGON
GLU
GLUCAGON
GLUCOSE 10%
GLX
GLUCOSE 10% (Latin suffix 'X' used to indicate '10'%)
GLYCERYL TRINITRATE (GTN)
GTN
GLYCERYL TRINITRATE
HEPARIN (STANDARD UNFRACTIONATED)
HEP
HEPARIN
The Future
• 2006
• Evidence based review of all
•
•
•
guidelines
Hyperlinks to Evidence
All Guidelines Group may comment
Secure Web-based development site