In The Face Of Paramedic Practice How The Pharmaceuticals will go ahead
The importance of Healthcare Pre-Hospital Emergency Clinical Management of integrity and leadership in adapting to changes within the field, stating, “The leadership legacy you leave is the life you live.” Jay Fitch.
Responding to an increasing volume of the widening sphere of Paramedical Call-outs within our Communities. Bears an enormous strain on an already over stretched services to delivery appropriate healthcare and, follow through on patients pathways- call before you convey- referral to Gp, and as is often the case referral for pharmacy to free up hospital admissions, via Gp or Specialist Paramedic.
The attendances at each patient in turn last between 1 to 3 hours from at scene to clearing from the patient.
Let’s take for example a patient whom has breathing difficulties triaged by ambulance receiving centre and allocated to an A/E crew. Given the consultation and thorough assessment the decision ; Is made through a myriad of differential diagnosis, encompassing presenting symptoms- patient setting-acute symptoms-ongoing chronic conditions- pharmaceutical treatment -care wants and needs- mobility-social services support-family support-Gp services etc.
This patient being identified as fit to remain in a home setting with family support, a referral is communicated to a doctor for top cover and any assessment/ consultation missed. A proposal – differential diagnosis supporting evidence for pharmacy communicated , patients consent and measures in place to collect pharmacy locally!
An evaluation that all too often, the patient is unable to collect the arranged for medication to support their much needed treatment.
Either patients mobility issues are too poor, or no existing family members can assist given location or only visit too infrequently. This dilemma creates a delay in the Ambulance clearing from the job and furthermore leaves only the Ambulance crew to collect pharmaceuticals.
A long drawn out process, of which the patient remains central to the clinical decision-making.
Utilising the many community referral pathways has many advantages, however given a further delay, doesn’t bode well for the Ambulance Crew to resume normal duties.
Other complications arise when on a late or night shift and at weekends, when external referral pathways within the Health board are not available.
This is an isolated example of pre-hospital care in our communities for the first time in a decade , and many years to come Ambulance crews modus operandi are going to find themselves triaging either self-care advice, referral, and referral with pharmacy; to keep our hospitals freed -up.
This underscores the need for Paramedics to embody the values and practices they wish to see in their teams, especially as the profession evolves to meet new challenges like technological integration, changing healthcare dynamics and pharmaceuticals .
