2017 Edition CPGs

The 2017 Edition CPGs will be released in the coming weeks and will be available on the PHECC website www.phecc.ie. This has culminated in over six months work reviewing, editing and designing this new edition. The implications for practitioners is that there will be a new round of up-skilling, following privileging, by their respective licensed CPG providers. Responders will be required to certify on the new CPGs as re-certification occurs.

 
New CPGs have been introduced for all levels and a significant updating has occurred to the existing CPGs.  Also, adult and paediatric CPGs have been combined where standard practice occurs across both age groups.  The tables below outline the new CPGs introduced for the clinical levels.

New CPG
 Description  AP  P  EMT 
Team Resuscitation This CPG outlines the team approach to resuscitation and defines specific roles X X  X 
Palliative Care This CPG outlines the care for a patient with a known, life-limiting illness who is currently receiving palliative care services at home X X   
Verification of death This CPG outlines the procedure for verification of death of a patient where death has occurred, cease resuscitation has occurred or an obvious dead body has been found X X   

 

New CPG for level
 Description  P  EMT 
Significant Nausea & Vomiting This CPG outlines the management of significant nausea and vomiting and authorises paramedics to administer Cyclizine or Ondansetron IM if indicated X   
PV Haemorrhage in Pregnancy This CPG outlines the care for a patient with PV haemorrhage in pregnancy   X
Postpartum Haemorrhage This CPG outlines care for a patient with postpartum haemorrhage   X
Umbilical Cord Complications This CPG outlines the management of a situation involving umbilical cord complications during birth   X

 

New CPG for levels
 Description  EFR  FAR  CFR 
Team Resuscitation This CPG outlines the team approach to resuscitation and defines specific roles X X X 
Asthma - Adult ​This CPG outlines the management of asthma   X  
Asthma - Paediatric This CPG outlines the management of asthma   X  
Harness Induced Suspension Trauma – Adult This CPG outlines the care for a patient suffering from Harness Induced Suspension Trauma   X  
Submersion Incident This CPG outlines the care of a patient involved in a submersion incident   X  

Spinal injury management CPGs has been completely revamped to reflect new evidence.  The emphasis for advanced paramedics (APs) and paramedics has changed to ‘spinal rule in’ and for all other clinical levels to reduce inappropriate practices such as use of the long board as a transport device, unnecessary log rolling and standing take down.  Details about PHECC’s spinal injury management policy is available at www.phecc.ie 

AP skills have been enhanced through wound closure clips and synchronised cardioversion. 

Paramedic skills have been enhanced through reduction of dislocation of patella, wound closure clips, external massage of the uterus (childbirth), CO2 monitoring, right sided ECG and management of significant nausea.

Some Medication changes:

  • New pain management medications have been made available, Ketamine for AP use and Methoxyflurane for use by EMTs, paramedics and APs.  Also, the dose of Ibuprofen has been increased for moderate to severe pain.
  • Adenosine has been introduced for SVT management by APs.
  • Benzylpenicillin has been replaced with Ceftriaxone as an antibiotic for AP use.
  • Chlorphenamine has been introduced for allergic reaction for use by EMTs and above.
  • Epinephrine use has been extended for AP use for severe croup (Neb) and cardiogenic shock (IV).