Paramedical Health Dictionary

The use of life-saving measures of mouth-tomouth resuscitation and external cardiac compression massage in a person who has collapsed with CARDIAC ARREST. Speedy restoration of the circulation of oxygenated blood to the brain is essential to prevent damage to brain tissues from oxygen starvation. The brain is irreversibly damaged if it is starved of oxygen for more than 4–5 minutes. Someone whose heart has stopped will be very pale or blue-grey (in particular, round the lips) and unresponsive; he or she will not be breathing and will have no pulse. It is important to determine that the collapsed person has not simply fainted before starting CPR. The procedure is described under car-diac/respiratory arrest in APPENDIX 1: BASIC FIRST AID. In hospital, or when paramedical sta? are attending an emergency, CPR may include the use of a DEFIBRILLATOR to apply a controlled electric shock to the heart via the chest wall.... cardiopulmonary resuscitation (cpr)

Apparatus that delivers a controlled electric shock to restore normal heart rhythm in patients whose hearts have developed VENTRICULAR FIBRILLATION or have stopped beating. The shock is delivered by electrodes placed on the chest wall or directly to the heart after the chest has been surgically opened. De?brillators are a standard item of equipment for paramedical sta? in ambulances, and aeroplanes of some airlines now routinely carry the apparatus. (See also HEART, DISEASES OF.)... defibrillator

A condition that needs urgent medical care. Examples include life-threatening injuries involving blood loss or damage to major organs, cardiac arrest or sudden loss of consciousness from, say, a blow or an epileptic ?t. Emergency is a term also applied to any resuscitative procedure that must be undertaken immediately – for instance, cardiopulmonary resuscitation (see APPENDIX 1: BASIC FIRST AID – Cardiac/respiratory arrest) or TRACHEOSTOMY. Patients with an emergency condition may initially be treated on the spot by suitably quali?ed paramedical sta? before being transported by road or air ambulance to a hospital Accident and Emergency department, also known as an A&E or Casualty department. These departments are sta?ed by doctors and nurses experienced in dealing with emergencies; their ?rst job when an emergency arrives is to conduct a TRIAGE assessment to decide the seriousness of the emergency and what priority the patient should be given in the context of other patients needing emergency care.

As their title shows, A&E departments (and the 999 and 112 telephone lines) are for patients who are genuine emergencies: namely, critical or life-threatening circumstances such as:

unconsciousness.

serious loss of blood.

suspected broken bones.

deep wound(s) such as a knife wound.

suspected heart attack.

di?culty in breathing.

suspected injury to brain, chest or abdominal organs.

•?ts. To help people decide which medical service is most appropriate for them (or someone they are caring for or helping), the following questions should be answered:

Could the symptoms be treated with an overthe-counter (OTC) medicine? If so, visit a pharmacist.

Does the situation seem urgent? If so, call NHS Direct or the GP for telephone advice, and a surgery appointment may be the best action.

Is the injured or ill person an obvious emergency (see above)? If so, go to the local A&E department or call 999 for an ambu

lance, and be ready to give the name of the person involved, a brief description of the emergency and the place where it has occurred.... emergency

A paramedical speciality concerned with the feet (see chiropody).... podiatry

a quality-improvement process that seeks to improve patient care and outcomes through systematic review. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team, or service level and further monitoring is used to confirm improvement in health-care delivery. The assessment, evaluation, and improvement of quality then forms a cycle of activity (audit cycle) that promotes sustained improvement (see diagram).

A distinction may be made between clinical audit, which refers to total care (involving doctors, nurses, paramedical staff, etc.), and medical audit, which refers to medical care specifically performed by doctors, although in practice the two terms are often used interchangeably.... clinical audit