Introduction of non-transport guidelines into an ambulance service: a retrospective review.
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.
Gray
J T
JT
Yorkshire Ambulance Service (South), Fairfields, Moorgate Road, Rotherham, S60 2BQ, UK. james.gray@yas.nhs.uk
Wardrope
J
J
D000488:Allied Health Personnel; D000552:Ambulances / Q000592:standards*; D003661:Decision Support Techniques; D004739:England; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies