JRCALC Clinical Guidelines 2022

Product Information

Full review and update of ACS. This includes a new section on health inequalities, women and racial differences. Strengthened wording, re. need to reduce on-scene time if possible.

Initial adult dose for oral morphine (not end of life) changed from 20mg, to 10-20mg, as it is now indicated for moderate pain. 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: 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. Aim for a systolic blood pressure (SBP) > 100 mmHg. Administration of fluids and adrenaline detailed. (See adrenaline above). Adult patients with a cardiac arrest of presumed primary cardiac aetiology should be transported directly to a hospital with 24/7 coronary angiography capability (Both STEMI and Non-STEMI patients).Updated guidance on mechanical chest compression devices and use of ultrasound. Other key changes include: In the event of symptomatic bradycardia in children/infants, first ensure that hypoxia has been reversed (the commonest cause of bradycardia). Reference list entry: Joint Royal Colleges Ambulance Liaison Committee and Association of Ambulance Chief Executives (2019) JRCALC clinical guidelines[app]. Version XX. Bridgwater: Class Publishing. Available from https://jrcalcplus.co.uk[accessed XX]. Over 2,000 multiple choice questionson the JRCALC Guidelines, covering the full breadth of paramedic practice, from vulnerable patient groups to obstetrics to trauma. Infants, children and adolescents (i.e. all those < 18 yrs age)-refer to termination of resuscitation and verification of death in children

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. The first update bundle of 2023 includes a new guideline for Agitated patients. This will sit alongside the existing guidance for acute behavioural disturbance (ABD). JRCALC are also in the process of developing new guidance on delirium. Agitation can have multiple causes and the clinical management can be challenging. The focus should be on identifying and treating, or arranging to treat the underlying cause. This video from Class Professional Publishing details all the updates made to iCPG and JRCALC Plus in September 2021.Diazepam oil in water emulsion is now a discontinued medicine, so this presentation will be removed from JRCALC. Diazepam solution will remain.

This new guideline will be placed in the General Guidance section. A short section on human factors will remain in ‘Out-of-Hospital Cardiac Arrest: Overview’. Additional wording for clarity has been added to Table 7.5 – High levels of supplemental oxygen for adults with critical illnesses: During the prehospital phase of care vital signs may not normalise and therefore patients with abnormal vital signs should continue to be administered high flow oxygen until hospital arrival.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. There is no evidence that cooling patients post-ROSC is of benefit, but extremes of temperature are harmful. Some patients post-ROSC will have a mild hypothermia. Ensure that patients do not become colder by using no more clothing/blankets than is necessary. Vehicle heating is only required to provide a comfortable ambient temperature.