Emergency medicine journal : EMJ
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How far is too far? Recent government policy and demographic growth have led to role changes within the professions in emergency care. Healthcare professionals have extended and expanded their scopes of practice to include duties outside their traditional role boundary. Nurses in particular are able to see and treat patients more independently. These expanded roles mean there is growing overlap between professional roles and responsibilities and one wonders-how far is too far? Where should role expansion cease? The aim of this research was to explore the perceptions of the professions on their current and future roles in emergency care. ⋯ Of genuine concern to the respondents was the lack of standardisation within the expansion of healthcare roles. In terms of "how far is too far", the respondents believed that greater clarification of training and scope of practice is required, enabling clinical roles to develop more consistently.
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To describe a prehospital thrombolysis (PHT) and expedited inhospital thrombolysis (IHT) programme in south-east Scotland using prehospital 12-lead ECG recordings transmitted by telemetry and autonomous paramedic-administered thrombolysis with decision support being provided by coronary care nurses. ⋯ Based on prehospital 12-lead ECG telemetry, it is possible for paramedics and CCU nurses to conduct live reperfusion decision-making in patients with STEMI, with resultant benefits in symptoms-to-thrombolysis time.
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Multicenter Study
Debriefing after failed paediatric resuscitation: a survey of current UK practice.
Debriefing is a form of psychological "first aid" with origins in the military. It moved into the spotlight in 1983, when Mitchell described the technique of critical incident stress debriefing. To date little work has been carried out relating to the effectiveness of debriefing hospital staff after critical incidents. The aim of this study was to survey current UK practice in order to develop some "best practice" guidelines. ⋯ Little is currently known about the benefits of debriefing hospital staff after critical incidents such as failed resuscitation. Debriefing is, however, widely practised and the results of this study have been used to formulate some best practice guidelines while awaiting evidence from further studies.