It provides a dynamic, accessible and affordable learning platform for ambulance staff that is evidence-based, contextualised and in a question style that is in keeping with the challenges that arise in practice. JRCALC combines expert advice with practical guidance to help paramedics in their challenging roles and supports them in providing patient care. The guidelines cover an extensive range of topics, from resuscitation, medical emergencies, trauma, obstetrics and medicines, to major incidents and staff wellbeing. The production of guidelines involves a huge amount of goodwill from a wide range of professionals for which we are all very grateful. From the JRCALC representatives to the individuals that make up the various guideline development sub-groups, all time and knowledge is volunteered, without which the JRCALC guidelines would not be possible.

We suggest a starting energy of at least 150J, escalating to maximum output for refractory rhythms. This session looks at what will be in the new guideline and indicates how to spot red flags and serious pathologies – along with when and when not to convey – and what are the assessment, management & analgesic options available to paramedics.Removal of wording in indications. The indication for TXA in women with post-partum hemorrhage if the patient continues to bleed remains. The following text has been removed: We are pleased to receive questions relating to the JRCALC Guidelines, however in the first instance we recommend that you liaise with appropriate senior clinicians within your organisation to clarify a guideline or area of practice. JRCALC is best known for the production of clinical guidelines for UK paramedics, often referred to as just the ‘JRCALC guidelines’. The guidelines are produced by JRCALC for NHS ambulance service paramedics, on behalf of the Association of Ambulance Chief Executives (AACE ). Working closely alongside the National Ambulance Service Medical Directors (NASMeD) who represent all UK Ambulance Services, JRCALC effectively fulfils the liaison role of its title.

In ‘Headache’ Table 3.62 Assessment and Management, bullet point removed: ‘Avoid morphine due to potential side effects, which could worsen the patient’s condition and/or hinder further assessment.’ Includes the 4AT Screening tool for delirium. Includes guidance on which patients may need admission or if a community referral is appropriate. The JRCALC iCPG and JRCALC Plus apps contain the complete and most current clinical guidance. Updates are published throughout the year, and the apps remain fully functional without a phone signal which always ensures the most up-to-date information for clinicians. The guidance is updated to place more emphasis on administering hydrocortisone for trauma as well as medical conditions, due to the physiological stress on the body for steroid dependent patients. This follows a coroner’s inquest where a patient died as a result of an acute adrenal crisis, caused by Addison’s disease and precipitated by the trauma of a fall and fractured hip. Insufficient administration of steroid medication by medical professionals was found to be a contributory factor in this patient’s death. Medicine guidelines have been removed, but are available on the iCPG and JRCALC Plus apps, where they are regularly updated to ensure that the most up-to-date guidance is available to clinicians.

OVERVIEW

Guidance on the assessment and management of this common presentation. Includes differential diagnosis, red flags, serious pathologies for hospital conveyance and guidance on those patients that may be suitable for community management or referral to primary care, pharmacological and non-pharmacological pain management, advise on simple exercises and safety netting. The publishers, Class Professional Publishing, will continue to provide additional updates to the 2019 Guidelines here. Reference list entry:Brown, S.N., Kumar, D.S., James, C. andMark, J. (eds.)(2019) JRCALCclinical guidelines 2019.Bridgwater: Class Professional Publishing. The IV route is re-included as a route for anaphylaxis for alleviating distressing cutaneous symptoms, only after emergency treatment with adrenaline and the patient is stable and oral anti-histamine administration is not possible. Infants, children and adolescents (i.e. all those < 18 yrs age)-refer to termination of resuscitation and verification of death in children