<p class="Pa2"><strong>Background</strong></p><p class="Pa2">To guide their care paramedics routinely rely upon two assessment and treatment algorithms, known as the primary survey and the secondary survey.  No clear consensus of the concepts (assessments and interventions) that are, or should be, included in these algorithms exist internationally. </p><p class="Pa2"><strong>Methods </strong></p><p class="Pa2">This paper evaluated Australasian paramedic clinical practice guidelines (CPGs), as well as six other international paramedic CPGs (USA, Ireland, UK, South Africa, Qatar, and the United Arab Emirates) in order to identify which concepts are currently described in best-practice recommendations for paramedics.  The authors also contributed concepts that they felt were important additions based on their experience as veteran paramedics and paramedic educators.</p><p class="Pa2"><strong>Results </strong></p><p class="Pa2">The resulting amalgamation of concepts identified in each term was then formed into two mnemonics which, together sequentially list approximately 100 specific clinical concepts that paramedics routinely consider in their care of patients. We describe these as the “International Paramedic Primary and Secondary Surveys”.</p><p class="Pa2"><strong>Conclusion </strong></p><p class="Pa2">The primary and secondary surveys presented in this paper represent an evidence-based guide to the best practice in conducting a primary and secondary survey in the paramedic context.  Findings will be of use to paramedics, paramedic students, and other clinicians working in remote or isolated practices.</p>

IntroductionThis paper discusses a trial of the use of CompTracker© – an online platform used to link the student, preceptor and academic in a time sensitive manner during student clinical placement – within a cohort of 330 first and second year paramedic students studying at an Australian university. CompTracker© allows for preceptors to identify and assess clinical competencies, and for the student to reflect after each case is completed on placement. The tool was initially piloted, and then remodeled on several attempts to improve its overall functionality and relevance for the placement learning experience. The study aims to educate and inform other health disciplines that may have an interest in using online tools for competency tracking and education in diverse workplaces. MethodsMultiple surveys were conducted over a 3-year period, using both Likert 5-point scales and open-ended questions, to evaluate 330 first and second year students’ and 261 preceptors’ experiences. ResultsOf the 54 student responses, 92% felt the tool was useful and 67% felt it was easy to use. Within the preceptor results, 63 ± 2% preferred CompTracker© over traditional paper-based methods. ConclusionCompTracker© can be used to support students and preceptors in clinical placement. The flexibility of this online tool makes it adaptable to most clinical workplaces, and should be considered in any workplace that requires the use of competency-based clinical assessment and used in place of traditional paper-based portfolios.

Paramedicine and the emergency medical services have been moving in the direction of advancing pharmaceutical intervention for the management of pain in both acute and chronic situations. This coincides with other areas of advanced life support and patient management strategies that have been well researched and continue to benefit from the increasing evidence. Even though paramedic practice is firmly focused on pharmacological interventions to alleviate pain, there is emerging evidence proposing a range of nonpharmacological options that can have an important role in pain management. This review highlights literature that suggests that paramedicine and emergency medical services should be considering the application of complementary and alternative therapies which can enhance current practice and reduce the use of pharmacological interventions.

Introduction There are 10 emergency paramedic services in Australia and New Zealand (Australasia), referred to as jurisdictional ambulance services (JASs). All 10 of the JASs in Australasia produce their own clinical practice guidelines (CPGs). With differing approaches to their review and implementation of new evidence, there is opportunity for differences to arise between guidelines. This article outlines a new series that will aim to identify interjurisdictional differences in CPGs and paramedic scopes of practice, and consequently differences in patient treatment depending on which jurisdiction a patient is geographically located within at the time of their complaint. Methods The current CPGs of each JAS will be obtained from each JAS, and content extracted by registered paramedics. The scope of practice for each intervention presented in the guideline will be classified as being at the level of ‘paramedic’, ‘intensive care paramedic’ (or equivalent, as titles vary by jurisdiction), or ‘restricted’. Each paper will be provided to each JAS for optional verification of content before publication, and the results of this will be stated. Conclusion This series will aim to provide a contemporary overview of Australasian JAS clinical practice guidelines and scopes of practice.

BackgroundThere are 10 state-run ambulance services in Australia and New Zealand, all of which are members of the Council of Ambulance Authorities (CAA). These CAA services use nine unique sets of clinical practice guidelines (CPGs) to direct the care that their paramedics deliver to patients. Although there are many similarities in these guidelines there are also notable differences in both structure and content. This paper is a comparative analysis of these CAA CPGs that contrasts the differences in organisation and also discusses the similarities and differences between the various CPGs themselves. This comparison was done as a preparatory exercise for the creation of a set of national CPGs by Paramedics Australasia.MethodsThe complete set of CPGs were obtained and analysed. All CPGs intended for operational road paramedics were examined. These included extended care paramedic, retrieval and intensive/critical care paramedic CPGs, and first responders. The 10 tables of contents were synthesised into one document and then restructured into a unique taxonomy determined by consensus of the authors. The authors reviewed the taxonomy to ensure the organisation was consistent and logical. Each CPG was then reviewed to ensure that it was appropriately placed in the new taxonomy. The CAA CPGs were further examined for similarities and differences independently by each author according to a predefined list of characteristics. ResultsA new taxonomy for Australasian CPGs is presented with a discussion of various issues of interest that became apparent during the development of the taxonomy. This taxonomy can provide guidance in the creation of a unified set of CPGs that can be used as a reference for developers, educators, clinicians, researchers, managers and industry representatives interested in consulting and developing a clear statement of the scope and standards of Australasian paramedics. The comparative analysis could be of interest to developers of CAA CPGs, and others. ConclusionThis paper presents a novel taxonomy, or scheme of classification, that incorporates all CAA CPGs in preparation for the development of a uniform set of Australasian CPGs, which will be of use to various individuals and organisations.