all areas of a healthcare professional’s work. In the United Kingdom, paramedics are accountable to the public and their profession through the Health and Care Professions Council (HCPC). There are two sets of HCPC standards that govern paramedic practice:
HCPC (2016) Standards of conduct, performance and ethics
HCPC (2014) The standards of proficiency for paramedics (latest review point 2020 to be published).
These two sets of standards apply to all areas of paramedic practice including medicines and pharmacological management (i.e. knowledge, understanding and clinical application) as related specifically to the paramedic role.
The HCPC (2016) and HCPC (2014) standards are essentially frameworks within which all registered UK paramedics must work. Ambulance services and paramedics outside the UK will be guided by equivalent organisations. Examples of these are:
Australian Council of Ambulance Authorities (CAA), covering Australia, New Zealand and Papua New Guinea: www.caa.net.au/
Paramedicine Board, Australia: www.paramedicineboard.gov.au/Professional‐standards.aspx
Australian Clinical Practice Guidelines: Ambulance and MICA Paramedics (2018): www.ambulance.vic.gov.au/wp‐content/uploads/2018/07/Clinical‐Practice‐Guidelines‐2018‐Edition‐1.4.pdf.
HCPC Standards of conduct, performance and ethics
This framework (HCPC, 2016) establishes what the expectations are for all UK‐registered paramedics specific to behaviour, public expectation and fitness to practise. The framework covers 10 specific areas of paramedic practice in relation to conduct, performance and ethics which in the context of this book can be applied to the specific area of medicines management as well as all other areas of a paramedic’s practice. These are:
Promote and protect the interests of service users and carers
Communicate appropriately and effectively
Work within the limits of your knowledge and skills
Delegate appropriately
Respect confidentiality
Manage risk
Report concerns about safety
Be open when things go wrong
Be honest and trustworthy
Keep records of your work.
Specific drugs and examples of application to paramedic practice, as well as legal and professional issues, can be read and explored in the chapters that follow.
HCPC Standards of proficiency for paramedics
This framework (HCPC, 2014) establishes what UK‐registered paramedics must do specific to their regulated profession, which in the context of this book can be applied to the specific area of medicines management as well as all other areas of a paramedic’s practice. There are 15 areas of proficiency covered by these standards with more detailed subsections under each proficiency. All paramedics must comply with the standards of proficiency.
Practise safely and effectively within their scope of practice.
Practise within the legal and ethical boundaries of the profession.
Maintain fitness to practise.
Practise as an autonomous professional, exercising their own professional judgement.
Be aware of the impact of culture, equality and diversity on clinical practice.
Practise in a non‐discriminatory manner.
Understand the importance of and be able to maintain confidentiality.
Communicate effectively.
Work appropriately with others.
Maintain records appropriately.
Reflect on and review practice.
Assure the quality of their practice.
Understand the key concepts of the knowledge base relevant to their profession.
Draw on the appropriate knowledge and skills to inform practice.
Understand the need to establish and maintain a safe practice environment
In order to fulfil these requirements, paramedics must have a level of pharmaceutical knowledge and an awareness of how and where to find appropriate information to support clinical practice. Contemporary healthcare regimes have resulted in a breadth of emergent new products and complex treatment regimens. As a paramedic student or clinician, you will need up‐to‐date, clear and concise information to guide your practice. Examples of this can be found in later chapters in this book as well as external sources such as the JRCALC and numerous other guides, websites, texts and resources that are readily available. However, ensuring a robust and evidence‐based or evidence‐informed selection of these is paramount. Some resources are web based, some print based and some digital app based.
This chapter aims to introduce you to using pharmaceutical and prescribing reference guides with a specific focus on:
JRCALC Clinical Guidelines (JRCALC, 2019a)
JRCALC Pocket Book (JRCALC, 2019b)
JRCALC app.
Pharmaceutical and prescribing guides are vital and valuable resources to draw upon to ensure safe, accountable and evidence‐based paramedic practice and patient care.
Clinical consideration
As an undergraduate paramedic student or practising paramedic, there are core approaches to the fundamentals of medicines administration you should apply.
For example, when administering any drug, the paramedic should make sure they have a full understanding of its mechanism of action and the expected physiological effect it will have on the patient.
When out in practice, make sure you know where to easily access this information in your JRCALC so you can check it quickly in an emergency situation.
Joint Royal Colleges Ambulance Liaison Committee (JRCALC) Clinical Practice Guidelines
The JRCALC Clinical Practice Guidelines are an essential resource for paramedics and other healthcare professionals, in emergency care, on the road and in the community. The JRCALC books and app combine expert advice with practical guidance to ensure uniformity in the delivery of high‐quality patient care. The books, available as either the comprehensive reference edition or the pocket guide, cover a wide range of topics, from resuscitation, medical emergencies, trauma, obstetrics and medicines to major incidents and staff wellbeing. They include an extensive UK drugs formulary and Page for Age drugs tables to assist in making medicines administration simple. To date, the hard‐copy publication has been revised every 2–3 years. The digital version, via an app, is also available for prehospital clinicians to download. The electronic app version is updated more regularly.
The JRCALC Guidelines make reference to the National Institute for Health and Care Excellence (NICE) where appropriate. NICE guidelines inform the breadth of the National Health Service (NHS) in England and are also subject to regular review, update or withdrawal. Independent providers and ambulance services