Clinical Updates: April 2025
Your monthly clinical update covering:VVED Consultations for small infantsNew requirement: VVEDconsultation for non-transport of infants ≤28 daysStrong recommendation for 29days–3 monthsDriven by patient safety reviewand expert consensusNot about removing autonomy —it’s about adding clinical supportRSI Checklist UpdateAddition of a pop-off valve checkfollowing a critical safety eventPrevents misdiagnosis of failedventilationReinforces value of checklists,even for experienced cliniciansAdvanced Paramedic PracticeProposalPublic consultation openFramework for advanced practiceregistration in primary care and critical careFacilitates further advancementssuch as prescribing rights and scope self-determinationBig implications for AVparamedics — see link in show notes to respondSTEMI Transfer PilotALS paramedics trialing regionalSTEMI transfersTarget: stable patientspost-thrombolysisReflects data showing most STEMIpatients are low riskPatient Safety FocusStanding height falls in theelderly: don’t underestimate riskRhythm misinterpretation:shockable rhythms missed or misidentifiedNo link between junior staff anderror rates — we all share responsibility, we are all vulnerableGuideline Monitoring:Palliative Care CPG9.9% increase in patients dyingat home — great outcomeNo major change in meds given —possibly due to barriers in the current CPGEvidence supports simplifying CPGCase Reports on Viva EngageRecent cases: paediatricrespiratory failure, polypharmacy overdose, snake biteSubmit your own case via the Vivatemplate Paper of the Month: PACKMaNTrialRCT comparing ketamine vsmorphine for trauma painFound no difference ineffectivenessPoints to multimodal analgesia asa next step in research, which is already AV’s approachEquipmentCheck Pop-off Valve position atstart of shift“Resus Ready” campaign comingsoonCardiac Monitor ReplacementProgram- New device comingDiscussion underway: do we needto carry everything all the time? Professional DevelopmentOpportunitiesCritical Care Summit – May 15–16,EssendonGrand Rounds (CPG + RMH collab) –May 27, Sunshine Hub or virtualTrauma Grand Rounds – June 18 atRoyal Children’s or online Small steps to transform youpracticeDeliberate practice = highperformance, visualisation and mental rehearsal make a differencePractice rhythm recognition Rehearse SITREPsResourcesParamedic analgesia comparing ketamine and morphine in trauma (PACKMaN): a randomised,double-blind, phase 3 trialPalliative paramedicine: An interrupted time series analysis of pre-hospital guideline efficacyProposal to regulate advanced practice paramedicsRhythm recognitionGet in touchX / Twitter / BlueskyJames: @JamesOz1 | @jamesoz1.bsky.socialBen: @ben_meadleyLinkedinJamesBenProducer: Liam Hennebry