and institutions informing these.
It is worth noting that the physical, hard‐copy JRCALC Guidelines text books are available through bookshops and are on sale separately from the digital app. The app is available to the public via the internet on a subscription basis. Ambulance trusts in the UK can also develop a ‘service‐specific’ version of the JRCALC app. This is referred to as the ‘JRCALC plus’, with most ambulance trust in the UK opting to use this resource for their employees rather than issuing hard‐copy books. Independent providers and ambulance services outside the UK who are interested in the ‘JRCALC plus’ option should contact the publisher direct. This JRCALC (app) resource offers the most current guidance as the digital format can be more easily updated.
Most of the content of the JRCALC Guidelines is universally applicable to NHS ambulance services. However, some modification of these may be evident in regional/individual ambulance services and independent and non‐UK ambulance service providers as approved by relevant clinical committees or equivalents to best meet the needs of local service users. Another area of modification to the JRCALC Guidelines for paramedics to be aware of may arise through research sanctioned by relevant research ethics committees.
JRCALC Update information
It is worth noting that the JRCALC Guidelines contain a section at the beginning of the text called ‘Update Analysis – “what’s changed?”’. This consists of a table containing update information about changes to specific guidelines since the last edition. It is split into sections which reflect those of the book, making it easy to find if there has been an update within the new JRCALC publication to a specific area of guideline since the previous edition (Figure 2.1).
Clinical considerations
Always make sure you have a copy of your JRCALC Pocket Book or app with you.
If you use your Pocket Book, make sure you check regularly for any updates which have happened since your book was printed.
You may inadvertently administer a medication incorrectly if you have not kept up to date with the latest guideline changes.
The knowledge that informs the paramedic profession and the subsequent complex application of this to clinical skills and treatment interventions are constantly changing and updating in response to new research. It is essential for paramedics to keep up to date with the latest changes in policy and procedure. A paramedic who is already familiar with using the guidelines should read through the updated sections when a new edition is published to check any guideline changes which may affect their practice.
Figure 2.1 JRCALC Guidelines – Update Analysis.
Source: Reproduced with permission from JRCALC Guidelines (2019a).
How to navigate the JRCALC Guidelines
This is a comprehensive resource book containing a wide variety of clinical guidelines and information for paramedics on a broad range of topics. Such a large reference guide can seem daunting at first; however, the text is laid out in a logical order, making information easy to find and access. The resource book is split into seven main sections.
1 General Guidance
2 Resuscitation
3 Medical Emergencies
4 Trauma
5 Maternity Care
6 Special Situations
7 Medicines
The approach taken by the Guidelines presents information specific to commonly used drugs and the practical administration of these. In addition, the Guidelines build on this by identifying where a particular drug should fit into the patient’s management plan in a variety of treatment settings (e.g. emergency situations). As such, pertinent information on a particular drug will appear in the Medicines section (section 7) but also in numerous other sections of the book, and successful navigation of this text by paramedics or other clinicians is essential to get the most out of the resource specific to medicines management and clinical application.
It is worth noting that the drugs are presented in alphabetical order in the Medicines section of the Guidelines.
Skills in practice: example of navigating the JRCALC Guidelines
A paramedic looking for information about morphine sulfate will find relevant information about the drug not only in the Medicines section (section 7) but also in other sections specific to other aspects of clinical application such as General Guidance (section 1), Medical Emergencies (section 3) and Trauma (section 4).
General Guidance section (JRCALC Guidelines, section 1)
This section contains a large amount of general information for paramedics covering a broad range of topics including staff health and wellbeing, pain management in adults and children, sexual assault and safeguarding. Each topic has its own chapter within the section. Paramedics can find specific information relating to medicines and their use in clinical practice in the Pain Management for Adults and Children and End of Life Care chapters. It is essential for the paramedic to use the information in these chapters in conjunction with the specific information found in the Medicines section (section 7). Referring only to information on the Medicines pages may result in missing vital information about special applications or clinical situations relating to a specific drug and lead to its incorrect administration in practice.
Clinical considerations
If administering an analgesic (e.g. morphine) or an opioid antagonist (e.g. naloxone) to a patient at the end of their life, make sure you check the Guidelines in the End of Life Care chapter in the General Guidance section (section 1) as well as the specific drug information contained in the Medicines section (section 7).
The End of Life Care chapter contains more specific medication guidance relating to end‐of‐life care situations and medications may be administered incorrectly if this special guidance is not adhered to.
Resuscitation section (JRCALC Guidelines, section 2)
The Resuscitation section contains information and guidance on a number of topics relating to various aspects of resuscitation. Chapters in this section include out‐of‐hospital cardiac arrest, basic and advanced life support, foreign body airway obstruction, return of spontaneous circulation, death verification, death of a child and tracheostomy and laryngectomy management. In addition to the general guidance for each drug found in section 7, specific information about the drugs used in prehospital cardiac arrest situations can be found in the overview section at the beginning of each chapter within this Resuscitation section. For example, the advanced life support