Introduction of non-transport guidelines into an ambulance service: a retrospective review.
Emergency Medicine Journal · 2007-09-29 · Observational study
Abstract
BACKGROUND: Recent government policy has looked at improving the role of ambulance services in delivering alternative care models for patients. OBJECTIVE: To review the outcomes of the introduction of some specific non-transport guidelines into an ambulance service. METHODS: A retrospective review was undertaken of the documentation produced from the use of these protocols in the first 4 months following introduction for appropriateness of use, and potential for risk of adverse outcome. RESULTS: Of 354 uses of the guidelines, 140 (39.5%) were considered inappropriate. A large number of these were cases where the issue was refusal of transport rather than a use of the guideline. Of the rest the more focused guidelines showed better adherence (hypoglycaemia 2/69 inappropriate, epilepsy 1/23 inappropriate) than the more non-specific guidelines (no apparent injury 17/84 inappropriate, minor limb injury 28/58 inappropriate). CONCLUSIONS: This short study suggests that focused guidelines can help support ambulance staff decision making; however, care must be taken to ensure safe practice and that these guidelines are not used to add legitimacy to poor practice.