Australian Ambulance Services for Adult - Essay Example

USTRАLIАN АMBULАNСЕ SЕRVIСЕS АDULT RЕSUSСITАTIОN Name Institution Lecturer Course Date Introduction Ambulance and paramedical services are required to follow the laid down clinic guidelines in their emergency practices in order to conform to the international acceptable guideline practices. In Australia there are several ambulance services include Ambulance Victoria that offer medical emergency according to the law of the relevant Australian authority. However, ambulance Victoria ensures that it follows the standard clinical guidelines during emergency cases. Australia laws require that any ambulance service that operates in Australia should provide the services of care and not necessarily transportation of the patients during emergency. According to Curtis & Ramsden (2011) that ambulance services should have qualified professional that can be able to carry out emergency service which conform to good clinical practices. Among the ambulance services offered by the Australian ambulances services include compression during cardiac arrest. Wu, et al (2009) argues that it is a complex procedure that is only carried out by experts and not lay individuals. This means that the ambulance service company should have experts who understand the guidelines stipulated in their clinical; practice guidelines. According to standard procedures, cardiac compressions are conducted in the absence of a pulse (Kramer-Johansen et al., 2007, p. 410). However, most medical experts have difficulties in assessing the presence or absence of a pulse hence the need for a standard guideline that will minimize the risks associated with poor assessments of a pulse. This essay discusses Australian ambulance services, the adult resuscitation guidelines and clinical practice guidelines in Ambulance Victoria; to determine whether it follows the standard clinical guidelines used in cardiac compression. Ambulance Victoria Service The services at ambulance Victoria are supported by the clinical practice guidelines that are developed and revised as per the Australian laws. The Ambulance Victoria is a private ambulance service company that operates as a private limited company. The guideline used by this ambulance service company is approved by the Australian ambulance service since they meet the required standards. The ambulance Victoria clinical practice guidelines that is used for ambulance services has several procedures that are used to assess different complications that may require ambulance services and paramedical services. The clinical guidelines for ambulance Victoria is titled as the cki8nical practice guidelines for ambulance and MICA paramedics which was approved by the ambulance Victoria medical standard committee. Although the guidelines are designed for paramedics, they can apply to other ambulance services. The guidelines have procedures for assessments of different medical conditions that may require emergency services. This is crucial so as to e3nsure that health professionals use the appropriate procedures during emergency. In addition, it has guidelines for trauma, cardiac arrest, respiratory difficulties among other complications (Townsend & Luck, 2012, p. 567). Cardiac Compressions During cardiac arrest, compression involves the actions that a paramedic uses in order to compress the chest of the victim without the use of artificial respiration. The practice is conducted during cardiac arrest and it is recommended that a paramedic should conduct compression as soon as he notices that there is an absence of life in the patient (Stiell et al., 2012, p. 1194).This implies that the compression of cardiac arrest victims is only performed when the individual is breathing at occasionally agonal gaps. However, there are no proper assessments procedures that can assess the possibility of presence and absence of pulse, paramedics have developed standard procedures that should be followed during cardiac compression in order to avoid the dangers associated. The recommend procedure for patient who has a pulse is to induce artificial respiration. In addition, lay individuals are not allowed to carry out compressions assessments in health care professionalism. Medical professionals also used compression when an individual is in trauma but the procedure is considered futile especially when there is not pulse. However, the practice is recommended for correction of arrests. The guideline for cardiac compression has a number of principles and practices that should be followed in order to attain satisfactory results (Townsend & Luck, 2012, p. 900). Principles of Cardiac Compressions According to the ambulance Victoria clinical guidelines practice, cardiac compression should be carried when the medical professional has assessed the absence of a pulse. This is because the compression is performed in absence of a pulse as per the international clinical practices. There are a number of parameters under which cardiac compression should be done in a health facility. Rate of Compression The rate at which cardiac compression is performed determines its success or failure. According to Field et al (2012), when the patient does not have a pulse during the procedure it is recommended that the procedure should take less time. According to the standard guidelines which are adopted by the Ambulance Victoria guidelines, any cardiac compression is supposed to be conducted at the rate of 100 minute. There is the need for timing devices in the room under which the procedure is dome in order to do the exercise correctly. The mostly used timing device is a metrotrome which is carried in the ambulance by ambulance crews. This timing device helps the crew to achieve the desired rates. There are units that are used for timing reminders during compressions, and ventilations. However, depending on the features of the airways compression can take different rates. For example, when there is an advanced airway there is the need for artificial ventilation that takes place without any pauses in compressions. In such cases, compression is done at the rate of 8-10 per minute. The occurrence of advanced ventilation makes the compression to progress at a high rate (Stiell et al., 2012, p. 1197). Ratio of Compression There are standard ratios that are used against ventilation so as to reduce complications of compressions. The recommended ration of compression to ventilation is 30:2. There are 30 compressions when two ventilations are done. However, there are pauses in compressions. As pointed earlier, where there is an advanced airway such as endotracheal tube in place, compression proceeds without any pauses for ventilation (Field et al., 2012, p. 362). This is called asychronomous compression and ventilations which tries to achieve ventilation at the rate of 6 per minute at the ratio of fifteen compressions to one ventilation (15:1). Depth of Compressions Recommended guidelines recommend that compressions should be done at the depths of 38-50mm. However, the new compression guideline stipulates that compression should be dome at a depth of at least 50 mm. There is a relationship between the survival outcome and the compression depth hence it is important to determine the appropriate depth for compression. However, more research is requiring establishing the correct depths for compression in cardiac arrest patients so as to improve the chances of survival among the patients. Interruptions of Compression Interruption of compression is dependent on the type of airways and the need for ventilation. The aim of compression is to ensure that there is enough oxygenated blood the flows in the patient system in order to improve the chances of survival. Compression tries to improve blood flow hence it is carried continuously. Any interruptions in the rate and timing of compression during cardiac arrest will decrease the efficiency of the blood that flows in the system. This explains the fact that compression is dome at the rate of 100 per minute so as to minimize interruptions. Hence, during compressions there should be the minimum possible interruptions in order to achieve better results (Kramer-Johansen et al., 2007, p. 406). Hand Placement The hand off time that should be observed during chest compression is 10 seconds. This is to ensure that the hands of the health professionals are busy and have minimal interruptions during the compression process. In addition, the health professional is recommended to use both hands for adults. However, compression in children should be done with one hand placement at the rate of 100 heat beats per minute (Handley, 2013, p. 69). Conclusion Ambulance services in Australia are guided by acceptable standard and clinical guideline practices that are approved by the Australian ambulance service. Importantly, ambulance services should have qualified professional that can be able to carry out emergency service which conform to good clinical practices. In addition, ambulance services that do not provide approved services are denied license ad operations. Among the elements of clinical guideline practices include cardiac compression guidelines for ambulance Victoria. The ambulance Victoria offer services according to the international standards in cardiac compressions. The parameters that are used in cardiac compression include rate of heart during compression, depth of compression, ratio of compression to ventilation and the maximum time for hands placement and interruptions. The ambulance Victoria guidelines can be recommended since they are within the acceptable standard guideline practices that are used during cardiac compression to increase blood flow. The rate of compression is 100 per minute which is the recommended rate. The clinical guideline practices for paramedics and MICA can be applying by other ambulance services since they have the recommended limits and practices for cardiac compression. The requirement for assessment in the guideline makes the guidelines have credibility. References Curtis, K & Ramsden, C 2011. Emergency and Trauma Care for Nurses and Paramedics. Amsterdam: Elsevier Health Sciences Field, R., Soar, J., Davies, R., & Akhtara, N2012. The impact of chest compression rates on quality of chest compressions – a manikin study Resuscitation, 83 (2012), pp. 360–364 Handley, A 2013. What is best chest compression? Trends in Anaesthesia and Critical Care, vol.3, no.1.pp. 68-71. Kramer-Johansen, J., Edelson, D.P., Losert H, Kohler, K, Abella B 2007. Uniform reporting of measured quality of cardiopulmonary resuscitation (CPR). Resuscitation, vol.74, no.3, pp.406–417. Stiell, I., Brown, S., Christenson, J., Cheskes, S., Nichol, G., Powell, J., Bigham, B., Morrison, L., Larsen, J., Hess, E., & Vailancourt, C 2012. What is the Role of Chest Compression Depth during Out-of-Hospital Cardiac Arrest Resuscitation? Critical Care Medicine, vol.40, no.4, pp.1192–1198. Townsend, R., & Luck, M 2012. Applied Paramedic Law and Ethics: Australia and New Zealand. Amsterdam: Elsevier Health Sciences Wu, J.Y, Li, C.S., Liu, Z.X, Wu, C.J, Zhang, G 2009. A comparison of 2 types of chest compressions in a porcine model of cardiac arrest. American Journal of Emergency Medicals, vol.27, no.7, pp. 823–829. Read More